|
HOME > ABOUT > PRESS > STATE BUDGET WOULD CUT HEALTH CARE FOR POOREST
Article published - June 12, 2008
Credit: PRESS DEMOCRAT
State budget would cut health care for poorest
Community clinics that aid Medi-Cal patients say solvency at stake, plead with doctors for support
By Martin Espinoza
Michael Murphy, a part-time real estate agent and college instructor, has a frank and dismal view of what will happen if the Russian River Dental Clinic no longer accepts Medi-Cal.
"My teeth would rot in my skull," said Murphy, a Camp Meeker resident whose jobs don't offer medical benefits.
Murphy sought relief from a toothache Wednesday at the dental clinic, where he received a deep cleaning and an appointment to get a tooth filled.
Such care is threatened by Gov. Arnold Schwarzenegger's proposed cuts to various health care services covered by Medi-Cal, the state's insurance program for low-income residents, to help close a $15.2 billion budget deficit.
The possible cuts include $73.8 million that would eliminate adult dental benefits. For the Russian River Dental Clinic, the loss is expected to be $313,000, well over 40 percent of its $724,310 operating budget. More than 1,400 patients receiving dental care there would be affected.
The West County Health Centers, the agency that operates the Russian River Dental Clinic, also stands to lose $152,000 in general Medi-Cal funding from its $577,000 mental health program, said executive director Mary Szecsey, noting that the proposed cuts could have far-reaching implications.
"Some of the funding for the threatened services affects the solvency of the entire agency," Szecsey said.
The West County Health Centers is part of the Redwood Community Health Coalition, a network of nonprofit clinics in Sonoma, Marin, Napa and Yolo counties.
The coalition's 11 health care sites in Sonoma County stand to lose approximately $6 million as a result of the possible cuts, according to Pedro Toledo, a coalition spokesman.
Medi-Cal, California's version of the federal Medicaid program, covers 6.7 million people, mostly families with incomes up to 100 percent of the poverty level, which amounts to $17,170 for a family of three.
State officials said Schwarz- enegger does not take these proposed cuts lightly, but because health care services represent such a large portion of general fund expenditures, cuts are unavoidable.
"When you have that large of a deficit, which is well over 10 percent of the general fund, the second-largest expenditure (next to education) cannot be exempt from reductions. . . . We have to contribute to solving the state's budget problems," said Stan Rosenstein, chief deputy director of the California Department of Health Care Services.
The governor's latest proposed cuts to Medi-Cal amount to a savings of $1.1 billion and would include:
A $614 million savings through a 10 percent reduction in payments for health care providers in fee-for-service and managed care plans, rates for some long-term care facilities, non-contract hospital rates and reduced funding for 22 public hospitals.
An $85.4 million savings by eliminating optional benefits, including chiropractic care, acupuncture, audiology, optometry, opticians and optical labs, podiatry, speech therapy and psychology, programs not required under Medicaid rules.
A $203.7 million savings through administrative cuts and changes, including reinstating quarterly status reports of family income.
A $31.2 million savings by reducing the allowable income level for two-parent households to 61 percent of the federal poverty level and requiring primary earners to work no more than 100 hours a month, regardless of income.
A $42 million savings by limiting the eligibility period for most emergency services for undocumented immigrants.
An $86 million savings by cutting nonemergency services, other than prenatal, nursing facility and breast cancer treatment, for new immigrants.
Local health care professionals this week held a forum at the Sonoma County Indian Health Project in west Santa Rosa. They warned of the impacts such cuts would have on the stability of community clinics.
Naomi Fuchs, chief executive officer of Southwest Community Health Center in Santa Rosa, said the proposed requirement for quarterly status reporting could result in a significant number of Medi-Cal patients losing their eligibility. Medi-Cal reimbursements are crucial to community clinics because they help pay for the cost of providing care to uninsured patients.
"We have, at best, a half-percent operating margin in a good year," Fuchs said.
Dr. Kelly Pfeifer, one of two medical directors for the Redwood Community Health Coalition, said cutting primary care at clinics will result in more emergency room visits.
"None of the optional programs listed in the governor's budget -- such as adult dental, mental health, optometry -- are truly optional," she said. "If you want to save dental costs, cap each patient an annual amount. All of us with dental coverage live with this. But don't prevent access to emergency and preventative dental care."
Because most of Sonoma County's community clinics are designated Federally Qualified Health Centers, they are exempt from the proposed 10 percent reduction in Medi-Cal reimbursement rates.
But Pfeifer and other health care professionals said reductions in reimbursement rates would make it even more difficult for patients to access specialty care among private practice doctors, many of whom refuse to take Medi-Cal patients.
"Now, with the 10 percent cut, more specialist are saying, 'No, we're not taking any more,' " Pfeifer said.
Rosenstein agreed that health clinics could be indirectly affected by the reimbursement rate cut.
"We are asking physicians to stay with the program," Rosenstein said. "We would ask them to help out with the state's budget problem by taking their share of Medi-Cal patients."
At the Russian River Dental Clinic, Dr. Debra Araujo, the dentist who performed Murphy's deep cleaning, said many residents would suffer from the proposed cuts.
"We're providing a service that these people wouldn't otherwise get," she said.
|
