Citing changes in Medicaid reimbursement and the delay of the construction of a new public clinic, HealthFirst Bluegrass is reorganizing and laying off some of its staff.
A letter from HealthFirst Bluegrass Executive Director William North announcing the cutbacks was delivered to the HealthFirst staff on Tuesday.
The letter said 21 positions will be eliminated, including three vacant positions that won't be filled.
Some staffers will see their hours changed. For example, North said, the staffs at HealthFirst's school health clinics will be offered 10-month contracts instead of 12-month contracts. Currently those employees work for HealthFirst during June and July when the school clinics are closed.
Many of the cuts are in clerical and billing positions where the needs shifted when HealthFirst moved from paper to electronic medical records, North said.
The net loss to HealthFirst, which has 141 employees, is about 12 people, North said. HealthFirst will be adding nine new positions to deal with changes in how service is delivered because of health-care reform. Some laid-off staff could apply for new positions, but they would lose their accrued benefits such as vacation time and seniority, North said.
The new positions include several registered nurses to serve as care coordinators and a number of people to specialize in outreach to help enroll the previously uninsured who, as part of health-care reform, will be eligible for insurance Jan. 1, 2014.
Medicaid managed care, another aspect of health-care reform, has disrupted HealthFirst's cash flow, North said. Medicaid owes HealthFirst about $1.2 million, and there is no indication when that money will be paid.
The construction delay of a public health clinic at 496 Southland Drive has also contributed to the strained bottom line. The $11.7 million federally funded clinic was originally scheduled for completion this summer, but construction has yet to begin and the land deal for the clinic site is under investigation by State Auditor Adam Edelen.
The clinic would serve as an additional source of revenue if it were open and serving patients, North said.
Kevin Hall, spokesman for the Lexington-Fayette County Health Department, said the health department is not considering layoffs.
HealthFirst and the health department once operated in tandem but HealthFirst became an independent non-profit in 2011. HealthFirst operates a public health clinic and is financed mostly through tax dollars.
HealthFirst's board of directors is scheduled to meet at 5:30 p.m. Thursday.