COEUR d'ALENE -

Kootenai County will spend just over $2 million on indigent care this fiscal year, down nearly $1 million from the year before.

The Kootenai County Clerk's Office issued a press release Thursday stating that citizens should be aware that property taxes pay for doctor, dentist, medicine and hospital claims for people who otherwise can't afford them, as well as for non-medical ones such as rent and utility payments and burials.

The law, active since the 1974, isn't funded by the state, although the state picks up the rest of the bills once the county has passed its cap.

Kootenai County Clerk Cliff Hayes said the system, also known as ‘County Assistance,' is "a burden to taxpayers."

"It takes over $2 million away from the taxpayers," he said. "They're paying for an awful lot of medical expenses for the citizens of Kootenai County."

Other county officials didn't classify it as such.

They said the program is helping people in need,and the cooperation between all the partnering entities lends those services cheaper than what they could be.

The real problem is national, they said, regarding health care expenses on a whole.

That's a bigger issue than just the county level.

"The welfare issue is a difficult situation for all entities involved, including the county," said Jai Nelson, commissioner. "It's just the sign of the times."

The assistance programs, both medical and non-medical, are pay-back programs for residents who qualify.

"It makes us sound like we're just spending money willy-nilly and we're not. We have a very in-depth investigative process," said Carrie McCrite, indigent director for Kootenai County Assistance, about the press release. "We are being good stewards of the taxpayer money, and we definitely scrutinize each and every case."

The medical program covers costs for medical emergencies and necessities, an example of the latter being for treatment for chronic conditions. The county determines from the household income and its allowable expenses whether the applicant can afford to establish a payment program for the bill.

If not, they can qualify, while provider rates are locked in at Medicaid and Medicare levels.

Non-medical aid is for people who can prove they are in jeopardy of being evicted or having the power shut off.

The county places a lien on qualifiers' properties to establish a pay-back plan. This fiscal year, the county has spent $1.2 million of the budgeted $2.3 million. It's recovered $115,225. Last year, it spent $3.2 million and received back $145,205.

Idaho is one of few states to have the mandated programs. This year, 1,890 people applied. Less were accepted, although the county couldn't track that number Thursday afternoon.

"No matter whether it's at the county level or state level, you're going to have to take care of your indigent resident. I don't want to be a quoted saying it's a burden or anything else, someone has to help. It's not going to go away, McCrite said."

The county payments are capped at $11,000. The remainder of the bills are submitted to the state.

Last year alone Kootenai Health by itself wrote off $3.3 million in charity care.

In 2010 the Kootenai County Assistance Program owed approximately $11 million to Kootenai Health from claims carried over several years, before the county and provider settled for $1.7 million. Nelson called that agreement "bending over backwards" to help the county.

Hayes said the financial responsibility should be at the state level, and not through local property taxes, or legislators should allow counties more avenues to collect revenue to cover the costs. In the meantime, the county is reviewing the cost of cremations over burials to see if money could be saved by requiring cremation should it be cheaper.

The county paid for 48 burials and cremations last year.