Sunday, November 29, 2020

Federal Funding a Recurrent Topic in Health Dept. Transition Hearing

By on November 19, 2020

Health Secretary Lorenzo González during a government transition hearing (Screen capture)

Secretary: Fiscal board-imposed cap ‘has to be discussed’

SAN JUAN — While a tumultuous vote-counting process continues, the transition team of Pedro Pierluisi, the gubernatorial front-runner and presumptive governor-elect, and the current administration already began to hold transition hearings, which on Wednesday focused on the Healthcare Department and the Health Insurance Administration (ASES by its Spanish acronym).

As is to be expected of a gubernatorial transition hearing in the middle of a pandemic, a large portion of Health Secretary Lorenzo González’s presentation and the ensuing questions were about the government’s response to the Covid-19. However, Pierluisi’s transition team also focused on federal funding, specifically on the problems the Health Department has had with federal allocations.

When Philippe Mesa Pabón, the head of Pierluisi’s transition committee on government affairs, asked the Health secretary if the department has maximized its use of federal funding, González said that while his administration had made improvements, the collection level for the $7 billion in federal healthcare funds available has been “deficient.” González went on to argue that the issue has to do with a lack of personnel. 

“I could tell you that we are at a 50 percent collection level on those [$7 billion]. Much work needs to be done. We paid a lot of attention to projects that had time constraints, expiration dates,” González said. “We have $7 billion and we don’t put the 100 people that we need to manage $7 billion.”

A lack of personnel affecting operations was also an issue that ASES Director Jorge Galva brought up. He highlighted that the budget approved by the Financial Oversight and Management Board (FOMB) for the agency was $42 million less than the agency-proposed budget. 

Another funding matter on the table was the about $1 billion in Medicaid funding that expired and went unused. The issue at the time was that this particular portion was approved by the Centers for Medicare and Medicaid Services (CMS) specifically to expand the Medicaid base, which would have meant that some 200,000 people who were previously ineligible could enter the government’s Vital health coverage program. The FOMB did not approve said use because the allocation was not recurrent. 

González argued that the fiscal board’s rejection came very late in the process, which left ASES and the Health Department unable to present an alternate use to CMS but that for this federal fiscal year’s allocation, the FOMB has given the green light to use it to expand the Medicaid base and the department and ASES are already making the necessary arrangements to use the funds. 

González brought up the fiscal board to complain about the cap that the panel imposed on the department’s revenue. 

“It’s important to recognize that the fiscal board has put a cap to what the Health Department can retain from its own revenue and the other part goes to the fiscal control board,” González said. “One of the things that has to be discussed in detail is to what extent we can eliminate that cap.” 

Aside from the internal monetary issues, González defended his agency and the commonwealth government’s response to the Covid-19 pandemic. He argued that one of the obstacles he encountered was that certain information systems and research offices he had established when he first served as secretary from 2009 to 2012 had been dismantled. 

Regarding a Covid-19 vaccine, González insisted that the Health Department was ready to distribute it, but that people need to have a clearer idea of the process because it won’t be “a million vaccines in one day.” Instead, he expects the first batch to be of about 50,000 units. Additionally, the vaccines will be made available in a prioritized fashion, with the first phase targeted toward healthcare workers and those considered at high risk.