COD E R E D

Until 1993, Denver Health (DH) was a component of city government. At that time, amayor-appointed panel consisting of community and business leaders met to determine neworganizational structures for DH: a not-for-profit corporation, a public benefit corporation, ahospital district, or a hospital authority. The hospital authority structure was recommended inorder to enable DH to exist as a more independent public entity. In 1994, Denver Healthofficially became a hospital authority with the intent to ensure the delivery of health care to theindigent and uninsured. In 1997, the Denver Health and Hospital Authority became anindependent entity governed by a nine-member board appointed by the mayor and confirmed bythe council. Another board that exists to govern the Neighborhood Health Program has 13-members board, of which 51% are DH patients in order to maintain federal funding.DH is a vertically and horizontally integrated health care system for indigent anduninsured populations in Denver. The system is centrally organized and consists of an acutecare hospital, an ambulatory center, 11 FQHCs, 13 school-based clinics and the local publichealth department. There is an integrated system-wide eligibility and referral system to helpguide patients to the appropriate health care services including public health, primary, specialtyand inpatient services. The system offers several different health care products. ColoradoAccess is a managed care product in which DH partners with several private providers in aneffort to maintain revenue from Medicaid patients. The Denver Health Medical Plan (DHMP) ismarketed to public employees and employees of small businesses. The DHMP also serves theCHIP population. DH also offers a program of inpatient and outpatient services to the prisonerslocated in federal and state correctional facilities in the Denver area. It provides a 911emergency response service, a locked forensics unit, a women’s care clinic, a 100-bednonmedical detoxification unit with nonambulance transport service, and the regional poisoncontrol center.EligibilityPotential enrollees must meet residency, income and asset standards. Income must notexceed 185% of the FPL. After eligibility is determined, the participant is assigned to a paymentrate category based on their income and assets.FinancingDH relies on a variety of funding sources for its programs but the primary source is theCounty Indigent Care Program (CICP). The CICP is a state program that reimbursesparticipating providers for a portion of the costs of treating eligible individuals. The participatingproviders must follow state-established limits for acceptable amounts to charge the eligibleindividuals. Thus the program aims to help reduce provider costs when administering carewithout compensation while also limiting the amount the low-income patient is required to payfor their care.For the fiscal year 2003-2004, the Colorado State General Assembly set aside$255,976,646 to reimburse the CICP providers. Three sources of funding for the program arefederal funds ($128,000,000), cash funds exempt ($115,400,000), and the General fund($12,576,646). Cash funds exempt refers to the DSH and Medicare Upper Payment Limitfunding. The CICP reimbursement to providers is based on previous year’s write-off costswhich are inflated for the upcoming year. For the fiscal year 2003-2004, the DH reimbursementfrom CICP was $64,704,089 and $38,037,301, respectively.D-8