A proposed $800,000 budget cut for Community Health Centers of the Central Coast could lead to the closure of two of its 17 countywide clinics, cut hours in half at four others and leave more than 5,000 uninsured and underinsured individuals without health care if the plan is approved by the county Board of Supervisors.
Supervisors are tentatively slated to hear the issue at 10:30 a.m. today in board chambers.
The county may pare its contribution to the program to $2.2 million from $3 million annually because San Luis Obispo County Public Health Services faces a $2.5 million cut in general fund money in the fiscal year starting July 1, according to Health Agency Director Jeff Hamm.
The county contracted with CHC in 2004 to take over six county-run medical clinics after the Board of Supervisors closed San Luis Obispo General Hospital.
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As part of that contract, CHC assumed coverage for county residents who qualify as patients under the County Medical Services Program.
That means, legally, the county has to ensure services to medically indigent adults — people who have low incomes, limited assets and a medical condition that requires treatment — if they qualify under federal poverty guidelines.
With the closure of General, the county initially underwrote CHC to the tune of $5.1 million a year. That amount has been whittled to $3 million as of this fiscal year.
Paradoxically, the number of patients that the clinics have been serving has been growing during that time to include more underinsured and uninsured patients — not just those who qualify under federal guidelines.
According to CHC officials, their patients are:
48 percent covered by CenCal Health Medi-Cal.
16 percent covered by Medicare.
13 percent covered by private insurance.
4 percent covered by Children’s Health Disability Program.
4 percent covered by CMSP.
The remaining 15 percent are those who are uninsured and don’t qualify for the above-mentioned programs.
District 2 Supervisor Bruce Gibson acknowledged that even as the county’s grant to CHC has grown smaller in recent years, the nonprofit’s operation “has expanded and is now holding steady.”
“If we do reduce their grant amount, they may well have to reduce their services somewhat,’’ Gibson said.
“However, the closures suggested in (CHC’s) letter to Jeff Hamm (the county’s public health officer) are wildly out of proportion to the proposed reduction,” Gibson added.
The current threat to funding for uninsured patients came in a March 18 letter from Hamm, who wrote, “The county can no longer afford to subsidize the provision of care to other low-income, unsponsored” patients who don’t qualify for or don’t have coverage under federal poverty guidelines for CMSP.
Hamm also said he hoped future discussions will produce an agreement that “allows CHC to continue to be the provider of primary and related medical care services to the county’s medically indigent adult population.”
Ron Castle, chief executive officer of CHC, said it can no longer maintain $5.1 million in contracted services with only $2.2 million in funding.
Instead, he requested “$2.5 million to serve the needs of the CMSP population and $1.5 million to secure the original contracted services allowing CHC to keep all facilities open for all uninsured county residents.”
In 2010, CHC provided 335,846 clinic visits for 74,285 patients, with about 24,000 of those patients being uninsured.
The CHC’s funding worries are further exacerbated by an anticipated $1.5 million cut in state funding and a $1.6 million reduction in money it receives from CenCal Health, which in 2008 started managing coverage for San Luis Obispo County residents covered by Medi-Cal.
The grants from the county equal about 5 percent of CHC’s 2010 operating budget of $58.5 million.
Gibson said that, because of the economy and the state and federal budget situations, “there’s a limit in terms of what the county can give CHC in the way of a grant. The budgetary situation doesn’t allow us to do much more than care for the CMSP patients.”
That said, he believes CHC is going too far in its proposed cutbacks.
Closing Cambria’s CHC clinic, for example, doesn’t make financial sense, Gibson said, because, “my last look at the numbers show it to be clearly in the black — because it has a large percentage of Medicare and insured patients. I have asked for updated financials to be provided.
“I believe the CHC threat in closing the Cambria clinic is nothing more than a negotiation ploy,” he said. So is a CHC postcard campaign under way for the past week, he added, which is “raising baseless fears in their patient population. I’m very concerned and disappointed in the approach.”
The CHC campaign, called “In your 2011-2012 budget hearings, make my Health a Priority,” began June 2.
“Five days later,” said Kena C. Burke, CHC’s government relations officer, “we have received more than 600 postcards from patients and community members, with comments such as: ‘I really need this help. Do you want me to go to the ER?’ ‘Where would I go to get help? We need CHC.’ ‘Without CHC, I would not be alive with my health problems.’ ”
The postcard campaign is “counterproductive,” Gibson said. “Running radio spots attacking our health care director they’re playing a very unprofessional game.
“We’ve had a very good partnership with CHC,” he added, “but they haven’t adapted to the changing reality of government funding.”
Staff writers Kathe Tanner and Cynthia Lambert contributed to this report.
Several services and clinics face changes
Cambria CHC Clinic
Morro Bay CHC Clinic
SLO Radiology Department
50 percent reduction in hours possible
San Luis Obispo Pharmacy
Atascadero CHC physician’s services
SLO Specialty Services
SLO Homeless Health Care Services