Health clinics in county lose chunk of funding

The county Board of Supervisors agreed to significantly reduce its funding to the Community Health Centers of the Central Coast, which will likely result in fewer services at clinics countywide.

The direct impacts of the $800,000 cut are not yet known, but could include the closure of two CHC clinics in Cambria and Morro Bay and limited hours at four others. A combative debate between Ron Castle, chief executive officer of CHC, and supervisors Monday made clear a divide between what county leaders say they are responsible for funding and what Castle believes is a larger obligation to the nonprofit network of community health centers.

The county plans to shrink its contribution to the program to $2.2 million from $3 million annually to meet cuts made to San Luis Obispo County Public Health Services.

During the heated public hearing, Supervisor Bruce Gibson chastised Castle for his salary — about $292,000 annually — and suggested that cuts be made within the organization instead of asking the county for more money.

The supervisors asked for more transparency related to the nonprofit’s financials — something that Castle said has always been available.

The county must provide funding for medically indigent adults — those people who have low incomes, limited assets and a medical condition that requires treatment — if they qualify under federal poverty guidelines.

CHC agreed to provide those services when it contracted with the county in 2004 to take over six county-run medical clinics.

In the face of budget cuts, county officials now said that they can no longer subsidize the cost of services to other residents — such as those who are uninsured but don’t qualify for the County Medical Services Program.

Castle argues that it is the county’s responsibility and that those patients are becoming “medical orphans” because of the cuts in county funding.

The county initially awarded CHC $5.1 million a year, but that amount has been cut annually and is down to $3 million this fiscal year.

Castle asked the county for $2.5 million for the next fiscal year, which starts July 1, to serve the needs of the CMSP patients and an additional $1.5 million to keep services intact countywide for uninsured county residents.

The possible closure of the CHC clinics in Cambria and Morro Bay led to several emotional pleas by former and current patients to the county to make CHC funding a priority.

The operating cost of the clinics is about $600,000 annually in Morro Bay and $600,000 a year in Cambia.

“Everything is on the table,” Castle said of the cuts that will be made.

“It shouldn’t be so alarming to the county that we are going to have to cut services,” he said. “We do not have an obligation to subsidize the county or to go bankrupt to keep their situation together.”

Several supervisors criticized the CHC for a recent postcard campaign and radio advertisements warning residents that changes in services were coming because of proposed cuts in county funding. Supervisor Adam Hill called it a “cynical and shabby approach.”

Castle said the campaign was not intended to slander the county but to give the supervisors a better understanding of the role the clinics play in the communities and of the people who rely on those services.

In 2010, CHC provided 335,846 clinic visits for 74,285 patients, with about 24,000 of those patients being uninsured.

The grants from the county equal about 5 percent of CHC’s 2010 operating budget of $58.5 million.