Wed
Feb 13 2008
11:41:am
Mayor Cunningham's political tin ear
By: R. Neal  shortURL

County mayor gives state of the county message

"There's a mind-set that business here is done by good old boys in dark, smoke-filled back rooms, and it's going to take a while for us to change that, but we're trying to make government as open and transparent as possible.

"Openness drives accountability and we're going to keep it open and look for ways to make it more open."

Mayor Cunningham gave his "state of the county" remarks to 50 members of the Blount County Chamber of Commerce. The guy is tone deaf when it comes to politics, and it overshadows what was an otherwise favorable report.

(I do find it curious that he seems to be satisfied with Blount County school performance as compared to Maryville and Alcoa. But the Mayor appears to measure it in terms of bond ratings rather than achievement, graduation rates, and the like.)

Topics:

GOB Govn't gettin' bigger & bigger-

Submitted by seejaneride on Wed, 02/13/2008 - 12:12.

SeeJaneRide
Simply put. He's just not a smart man. Blount County government has grown like ugly weeds under the direction of the GOB network that now includes Cunningham as Mayor.
Latest case in point: The "free" medical clinic offered now for Blount County employees is being "expanded" for the children of our county-paid workers. Uh-huh.
As most of you with children know the medical protocol for the under 18 set is vastly different than that for adults. A fact not lost on Blount pediatricians who tried to raise the red flag on this practice at last night's Public Service meeting. The last thing they want to see is a child showing up in their office who is misdiagnosed by someone not qualified to treat children.
But the county's HR director, Betsy Cunningham says not to worry, they are hiring ANOTHER nurse with experience in pediatrics. And, who gets to pay for that? You! Keep in mind, these employees have taxpayer-funded health insurance. But NOW the GOB-led government is giving them another perk and exposing the county to the added liability of a kid getting the WRONG diagnosis.
Finally, does anyone find it interesting that these are the type of programs that Republicans usually rally against? Led by the Mayor and Budget Director, Bennett (also the Republican party chair!) they are creating the county's first socialized medicine program! And, to beat all it benefits their families. So, what's next? Free dental exams and root canals for all county employees? Hey, wonder what Commission Chair Doc Ramsey would say about that?

Not familiar with the clinic

Submitted by R. Neal on Wed, 02/13/2008 - 12:16.

Not familiar with the clinic issue, but it's interesting. I'm guessing it is a cost savings measure, especially if the county is self-insured. (Are they?)

It's actually a pretty good idea, and should be a good deal for county employees (and the county), assuming they can work out the details on the pediatric and/or other issues you mention.

What would be great is if they opened it up to the needy and uninsured if they were able to pay a small fee for services, or even subsidized it a little for the neediest. This might keep some people out of ERs.

The clinic has been open to

Submitted by concerned for BC on Wed, 02/13/2008 - 13:01.

The clinic has been open to adult patients. Opening it to kids is wrong. Kids need their own doctors, not just occasional visits at a clinic. In fact, grown-ups need their own doctors, too. But grown-ups are only going to see a doctor on a regular basis when things start falling apart or falling off! Has anyone heard of the Health Department? The Health Department gives shots to kids whose insurance doesn't pay for shots or like Blount County Government employees, insurance only covers shots at wellness visits. I believe the Health Dept has providers to see people. If the county is so worried about its employees having to pay a co-pay, then subsidize the co-pay. Co-pays are contracts set up by the insurer and the employer. How much do employees pay for their health insurance anyway? Many people pay huge premiums and deductibles. There are many people who would consider a co-pay and no deductible a bargain. Now the hospital is hiring a nurse practitioner with more kid experience The hospital will take a financial hit now, but will raise its contracted fee at some point. How much does the hospital get paid for the inmates who get seen in the ER? All this comes from our tax dollars. The services are not being provided to uninsured, they are being provided to people with insurance. There is duplication of services, but for only a select few. Our tax dollars pay for the Health Department, county employee benefits and now the clinic available only for employees. I am appalled at the nerve of the hospital and county. If something is not endorsed by the peds in the county, there must be a problem. Think twice and three times before risking your kids. Why doesn't the hospital have a pediatric ward? HMMMMM!!!!

As a working uninsured

Submitted by ABlevins on Wed, 02/13/2008 - 13:47.

As a working uninsured person who has been to both GS clinic and the Health Dept I can tell you that these places are swamped with patients. Care is minimal at best. They do the best they can with the little they have to do with, but if one has a serious health issue you will not get the care there you need. No mammagram, no doctors at the health dept just nurse practioners. I am thankful for them, but it is not enough.
So I am working to pay health services for people making more money than me when I cannot afford insurance for myself? Am I surprised? Not at all.

Injustice anywhere is a threat to justice everywhere.
Martin Luther King, Jr.

Brilliant

Submitted by Dumping Ground on Wed, 02/13/2008 - 14:03.

So I am working to pay health services for people making more money than me when I cannot afford insurance for myself?

I would love to hear, any government official - on any level, try to answer that question.

I too, am waiting for the

Submitted by ABlevins on Wed, 02/13/2008 - 14:07.

I too, am waiting for the answer to this question. I am not alone.. Most of my friends who are on the same income level as I, do not have health insurance if it is not offered at their workplace. I am not talking about minimum wage jobs. I am talking $23,00-$30,000 dollar a year wage earners. With the costs of housing, utilities, the rising costs of clothing and groceries who can afford $100-$250 a month for health insurance?

Injustice anywhere is a threat to justice everywhere.
Martin Luther King, Jr.

You are correct, your tax

Submitted by concerned for BC on Wed, 02/13/2008 - 18:11.

You are correct, your tax dollars are paying for a free clinic for Blount County employees, spouses, retired employees and now kids over 6. Their insurance coverage is paid for by tax dollars. It is great that employees get insurance coverage, but in a government setting with BC schools being what they are, it doesn't seem right to have a free clinic for people who already have insurance. Are the co-pays and deductibles so high that employees can't afford to go to the doctor? The employee clinic has nurse practitioners like the Health Department. Are the employees required to work when they are sick? Is that why they need a clinic? Do they need to shorten time away from their jobs to be seen at the clinic? Sick people should be allowed to stay home and get better. BC government must be a whole lot better than most governments to get people to stay on the job while they are sick. Just a thought!

I am ok with government

Submitted by ABlevins on Wed, 02/13/2008 - 23:04.

I am ok with government employees having benefits. We must have these things so that we can maintain quality people working for us in government jobs. I have no problem with that.
As many must do, government workers should pay their part in their own health care.
There should not be insurance and also a public funded free clinic payed for by citizens for only government workers. There should be insurance for government workers and also health care for uninsured workers.

Injustice anywhere is a threat to justice everywhere.
Martin Luther King, Jr.

Sadly, a young girl died in

Submitted by concerned for BC on Thu, 02/14/2008 - 08:25.

Sadly, a young girl died in Nashville from bacterial meningitis (reported 2/14/08). Isn't there a shot to keep kids from getting meningitis? If the clinic doesn't give shots (told at Public Services meeting), what is going to happen to kids whose parents think they are done with their shots and don't get the right ones? One life lost is one too many.

Who decided to open clinic up to kids?

Submitted by concerned for BC on Fri, 02/15/2008 - 08:59.

Who came up with the idea to open the free clinic to kids? Is there a need? Did the county ask the peds if they were having problems seeing kids of Blount County employees? Were Blount County employees complaining that they had to take their kids to the doctor and pay a co-pay? Do we need more peds in the county to see kids? Is that the problem? Does the county and the hospital (doesn't have a peds ward) think they can do a better job caring for kids? If I was a doctor, I wouldn't go to an area where the hospital competes with doctors in the area. Will a free clinic cause doctors' offices to close or lay off people? That seems to be a set up for loss of tax revenue. Doesn't make sense!

I have asked numerous questions in my comments, but have not had any answers. Commissioner Walker obviously reads this, can Commissioner Walker answer my questions? I am extremely curious about how much this clinic costs and how many people are seen in the clinic. Someone needs to try to convince the taxpayers of this county that having a free clinic for people with insurance is a cost effective move. Those same people need to convince parents that their kids are safer being seen at the clinic than being seen by their own doctors. The ball is in your court.

Yes.....You rang...

Submitted by commissionerwalker on Fri, 02/15/2008 - 09:24.

My feeble attempt to provide answers to questions...

Who came up with the idea to open the free clinic to kids?

It's not open to all kids, only those who are dependents that are on Blount County Government Insurance.

Is there a need? Did the county ask the peds if they were having problems seeing kids of Blount County employees?

If the parents (Blount County Employees) are taking them to the clinic, I suppose the parents feel a need.

Were Blount County employees complaining that they had to take their kids to the doctor and pay a co-pay?

There was a voice from those who had a primary care physcian, everyone else simply went to the ER.

Do we need more peds in the county to see kids? Is that the problem? Does the county and the hospital (doesn't have a peds ward) think they can do a better job caring for kids?

Questions 1 & 2 - Don't know, I suppose there are adequate peds in the Blount County area.
Question 3 - No, I do not think this is the case or they would open a ped ward.

If I was a doctor, I wouldn't go to an area where the hospital competes with doctors in the area. Will a free clinic cause doctors' offices to close or lay off people?

This is not addressing a county wide free clinic that may or maynot cause what you have stated above.

Sorry couldn't quote the remainder of your post. I can attempt to answer questions, but the answers will not be satisfactory. The cost for the clinic is paid for out of the savings realized to the self insured fund of Blount County. To-date those cost had run about 13,000,000.00 a year and increased at a rate of 13% per year. The thought process was that a preventative type program may curb some of the cost, it was also thought that if employees could be persuaded to utilize the clinc it would cut the cost of ER visits (these cost impact both the insurance fund and the employees at a larger rate than Dr. office visits)

I hope this helps in this discussion.

Clinic for government employees who have insurance

Submitted by concerned for BC on Fri, 02/15/2008 - 13:29.

Commissioner Walker, thank you for attempting to answer my questions. A question you can't answer would be the following: Are the people complaining about the cost of going to the doctor, the ones who use the ER? According to my insurance co-pays, the ER is significantly more expensive. I may not have to pay at the door, but I get billed. Some insurance companies deny payment if the ER visit is not a true emergency. Employees should be encouraged to get a primary care doctor. There seem to be plenty of docs who see adults. The ER is overrun with people who use it as a primary care clinic. It seems to me that Human Resources should really educate employees about the need for a primary care doctor and East Tennessee Medical Group amongst a number of other groups and doctors are available with evening appointments. The county has an obligation to track utilization of the ER and find out why it's being used so much and correct the problem. If someone is well enough to work, they can wait until they are off the clock to see a provider at one of the clinics that offers pm appointments. I am sure many folks who go to the government run free clinic are on the clock. I still would love to have the answer to my question about who came up with the idea to start seeing kids. It is a dangerous prospect and one I hope is not regretted. I thought the clinic wasn't going to do what you called preventative care. They aren't giving vaccines. There is alot that needs to be put on the table. Thanks for the feed back....you still have not convinced me this is saving tax payers money. Nor have you convinced me that parents will make the right choice in taking their children to the clinic. What has been done is illustrate that human resources needs to educate people on navigating the health care system.

Good Samaritan Clinic

Submitted by seejaneride on Wed, 02/13/2008 - 12:35.

SeeJaneRide
The Good Sam clinic is already available for needy and uninsured in Blount. The bottom line: docs HAVE to approach child medical care differently than adults. You can't just take a child to a clinic and expect them to be given the care they deserve with under-qualified personnel. And, if they give a bad diagnosis, and the child worsens, who is left holding the liability there?
Each time you take a child to a pediatrician, they are screened for current immunizations, growth, nutrition, and of course, they create a medical history. Pediatricians look beyond the runny nose.
I assure you, this isn't about saving the county a dime. It's about creating a perk, and a new revenue stream for Blount Memorial which contracts for the clinic. Interesting tho--the hospital doesn't even have a pediatric dept. Hospital pediatric care is available only in Knoxville.

Thanks for the info re. Good

Submitted by R. Neal on Wed, 02/13/2008 - 12:57.

Thanks for the info re. Good Samaritan Clinic. More info here if anyone is interested or, like me, didn't know about it:

(link...)

Wonder why the County didn't just contract with them?

I will defer to your expertise on the issure re. pediatric care.

Does anyone know if Blount Co. is self-insured?

The county is self-insured.

Submitted by concerned for BC on Wed, 02/13/2008 - 13:10.

The county is self-insured. Will having a clinic put them at increased liability for poor outcomes? I agree with See Jane, who will get left holding the bag if something turns sour? Who gets sued? Will the county be at risk? Will the hospital get sued? Will the doc who has to clean up the mess get sued? I still am not sure how paying a contracted fee to the hospital saves money. Doesn't the county pay health premiums? Didn't the county lower costs when it dumped Highlands? I bet the hospital wasn't too excited about the county getting rid of Highlands. Should a hospital be able to compete with doctors in the community? Will this action keep qualified doctors from this area? After all, who would want to send people to a hospital that is doing its best to put the doc out of business? Even though the county is making this a money issue, I bet if you called a ped, you would find out it is much more than money.

self insured on medical only

Submitted by mello on Wed, 02/13/2008 - 13:26.

FYI, the county dental plan is not self insured.

Who insures the dental?

Submitted by Dumping Ground on Wed, 02/13/2008 - 13:39.

Who insures the dental?

BCBS

Submitted by mello on Wed, 02/13/2008 - 14:33.

BCBS is the insurance carrier for the county dental plan.

Wonder why the County didn't

Submitted by ABlevins on Wed, 02/13/2008 - 13:49.

"Wonder why the County didn't just contract with them?"

Read my post above why the county does not contract with these clinics.

Injustice anywhere is a threat to justice everywhere.
Martin Luther King, Jr.

Maybe y'all should start

Submitted by R. Neal on Wed, 02/13/2008 - 13:27.

Maybe y'all should start another thread about this specific topic? It's interesting and informative.

Can you---

Submitted by seejaneride on Wed, 02/13/2008 - 13:44.

SeeJaneRide
R Neal--as administrator of this site, can you "move" these replies/responses into a new thread? The initial post about the clinic was in response to Cunningham's "all is well here" speech. Well, yeah, it's just peachy here when the GOB is creating more government programs but only for a select few!

can you "move" these

Submitted by R. Neal on Wed, 02/13/2008 - 14:19.

can you "move" these replies/responses

Not easily. Let me check on that.

OK, found a utility that is

Submitted by R. Neal on Wed, 02/13/2008 - 14:41.

OK, found a utility that is supposed to let me do this.

Question about that fund

Submitted by Andy on Thu, 02/14/2008 - 00:22.

Can recurring expenses, like payroll, be paid out of this general services school fund, as the Mayor suggests?

According to the mayor's presentation, the debt services fund, which helps the county obtain credit, now has $8 million and the general services school fund has almost $6 million, which will allow the county to open and staff the county's new schools.

I would really like to see the list of companies that have been turned away by the Mayor and friends, from location in Blount County:

"We've turned some businesses that approached us away because we don't want chimneys belching out black smoke."

Although I agree with him that there's enough blowing smoke around here. Seems like there was some billowing from the Chamber of Commerce, just last Monday:

"There's a mind-set that business here is done by good old boys in dark, smoke-filled back rooms, and it's going to take a while for us to change that, but we're trying to make government as open and transparent as possible.

Hey! Maybe if you try sitting out on the deck more, the government will become more open and transparent. No wait, that has already been done.

"I think it would be a good idea."
-Mahatma Gandhi, when asked what he thought of Western civilization

Can....

Submitted by commissionerwalker on Thu, 02/14/2008 - 10:05.

Can recurring expenses, like payroll, be paid out of this general services school fund, as the Mayor suggests?

There is a minimum, I believe it is 3% of the total school budget which must be maintained in fund balance. In order to go below this amount it becomes more restrictive, like not spending on re-occuring items and other restrictions.

However, the amount over the 3% can be spent on about anything the school board deems necessary, such as new school openings.

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