Jefferson County commissioners heard a presentation about a proposed primary care expansion agreement for Cooper Green Mercy Health Services during their committee meeting Tuesday.

After lengthy discussion, commissioners moved three related items to the agenda for Thursday’s commission meeting. The discussion included concern among commissioners that more of the most needy in the county could be pushed out.

“If I can cut at the top, it’ll allow me to expand at the bottom,” Commissioner David Carrington said. “I’m concerned that we are servicing families with higher income and that prevents us from serving families with lower incomes.”

Currently, the county serves individuals who are at 200 percent of the poverty level and below.

“If we’re at 200 percent of the poverty level with no copay, there are a lot of people that can’t get service,” Carrington said. “The more people you let in at the top, the fewer people we can service at the bottom.”

Carrington also expressed concern about the current no-show rate of Cooper Green patients who do not keep their scheduled appointments. He added that having a minimal copay could lower the number of no-shows by placing value on the service.

“If you have no skin in the game,” he said, “there is no value.”

Deputy county manager Walter Jackson said everything should be done to serve the needy. He acknowledged that having “skin in the game” adds value, “but there are a lot of people (for whom) even $15 hurts.”

County manager Tony Petelos said the neediest in the county have been served even since in-patient care ceased at Cooper Green.

“We’ve never shut the doors,” he said.

Armika Berkley, executive director and CEO of Cooper Green Mercy Health Services, presented the primary care expansion agreement, which is based on a hub and spoke model with Cooper Green serving as the hub and its partners serving as the spokes.

An addendum to the committee agenda included contracts with three prospective partners – Alabama Regional Medical Services, Cahaba Medical Care Foundation and Total Foot Care, P.C. The contracts called for $150,000 each for ARMS and Cahaba Medical, and $73,632 for Total Foot Care.

“Those spokes get us closer to individuals,” she said, noting that patients of those partners hose individuals would not have to drive downtown for primary health care. “If they have to take off work or drop their children off, they can go hopefully somewhere nearby.”

Commissioner Sandra Little Brown said Cahaba Medical Care centers in West End and Bessemer are spokes that are already in place. Carrington cited Christ Health Center in Woodlawn as another potential partner.

Berkley said she hopes that, provided the matter passes Thursday, formal partnerships can be established by the end of February.

The executive director and CEO of Cooper Green Mercy Health Services said the new partners could also reduce the backlog some patients experience. She said some patients have to wait at least 30 days to receive primary health care.

“It’s unreasonable,” she said. “Eventually, you go to the hospital. We don’t want that. That’s not the best place for you to be. Financially, it’s not the best place for any of us. We want people to access those walk-in clinics with our spokes.”

County’s Preparations for Scams

In another matter, Petelos noted an attempt to scam the county that was questioned by John Henry, the county’s chief financial officer. Henry said scammers are able to determine the leadership structure of a business or government entity and craft email correspondence that could trick someone into sending money to them.

“They’ll send an email to someone like myself or someone in the finance department and ask for a payment, or for an invoice or a vendor to be paid,” Henry said. “They say they’ll provide information at a later point in time.”

Henry said a warning of this scam was given when he attended the most recent meeting of the Government Finance Officers Association.

“The good thing is Jefferson County has put in a number of policies and procedures in reference to the way that we process payments,” he said. “That’s why we would check with the county manager and try to get more details in reference to that payment. Once we started to check, we realized the email was a scam.”