Miami-Dade commissioners allow federal healthcare navigators on county properties

10/01/2013 5:36 PM

10/01/2013 11:46 PM

On the first day that consumers could shop for Obamacare insurance plans, the Miami-Dade County Commission quietly took steps to defy Gov. Rick Scott’s order banning federal coordinators from local health departments.

Commissioners unanimously approved a last-minute proposal Tuesday to allow so-called “navigators” on county-owned facilities. But it stopped short of mandating that the navigators work at county-owned health buildings run by the state.

Instead, the board asked Mayor Carlos Gimenez’s administration to review the county’s health-department leases with the state and, over the next 30 days, come up with options to allow the navigators entry to those properties to educate people and help them sign up for insurance.

Commissioners also formally asked the Florida Department of Health, which is under the governor’s direction, to repeal its ban.

In addition, commissioners instructed administrators to draw up a list of county properties, including office buildings, libraries and parks, where navigators could hold activities, and to let navigators use those facilities if they want.

“We have nearly 35 percent of Miami-Dade’s population that’s uninsured,” Commissioner Jean Monestime, who sponsored the measure, said after the meeting. “It’s important to allow these individuals to seek access to healthcare.”

In neighboring Broward County, a commission made up almost entirely of Democrats flouted the Republican governor’s ban last week to much fanfare, ordering county-owned facilities run by the state health department to let the navigators in.

Not so in Miami-Dade, where a commission with a GOP majority treaded more carefully, even though several members called the ban a bad idea. The mayor and commission posts are nonpartisan.

Miami-Dade, Florida’s largest county, has the largest number of uninsured residents under 65: some 744,000 people, or 34.4 percent of the county’s population. Broward has the second-highest rate, 26 percent — about 396,000 people. Florida has the second-highest uninsured rate in the state, after Texas.

Early last week, Gimenez and several commissioners said they would welcome the navigators. They did not share the governor’s concerns that patient privacy could be compromised by their work.

When asked last week about Broward and Pinellas County in Tampa Bay spurning his agency’s order, Scott referred questions to the Department of Health. In a written statement, the department criticized the move because it “rejected the Department of Health’s guidance to protect patient privacy and ensure patient confidentiality in County Health Departments.”

Miami-Dade administrators found late last week that the county owns six of 29 local buildings operated by the health department. The rest are either leased by the state or by the cities of Miami or South Miami.

The county’s tally is slightly higher than the one from the Department of Health, which had found earlier that the county owned five of 23 local buildings.

Monestime, a Democrat, kept his resolution close to the vest until Tuesday’s meeting, when it appeared listed as one of several 11th-hour items that any commissioner could choose to delay. But none did. When the legislation came up for a vote, there was no discussion.

The vote was 8-0, with Chairwoman Rebeca Sosa, Monestime and Commissioners Bruno Barreiro, Esteban “Steve” Bovo, Audrey Edmonson, Barbara Jordan, Javier Souto and Xavier Suarez voting in favor.

Vice Chairwoman Lynda Bell and Commissioners Sally Heyman, Dennis Moss and Juan C. Zapata were absent from the meeting.

The vote coincided with the unveiling of health-insurance plans offered under the Affordable Care Act, which consumers were in theory able to begin browsing Tuesday, though the federal website was down much of the day.

The federal government has paid to train navigators to assist people in understanding their options and making a choice. Miami-Dade County took part in two grant applications for navigator funding earlier this year but did not receive either of the awards.

Deputy Mayor Alina Hudak said the county has a good relationship with the local health department and also plans to work with the public Jackson Health System to assist residents seeking health insurance.

Operators of the county’s 311 information line and public-library staffers have been advised to direct callers and residents to the federal healthcare website or telephone hotline. Though library staff cannot assist consumers with insurance enrollment, the library system’s homepage features a box titled “Easy Guide to the Affordable Care Act” to provide links and basic information about the program.

“We’re doing everything we can possibly do to use our resources to get people the information they need,” Hudak said.

Miami Herald political writer Marc Caputo contributed to this report.

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