Enough already! Last week’s public sparring between the county Board of Supervisors and the chief executive officer of the Community Health Centers called attention to a long-festering problem — but it brought us no closer to a solution.
Both sides need to negotiate a reasonable compromise to this budgetary tug-of-war that will not involve any clinic closures.
It’s time they refocused on the main issue: The uninsured and underinsured patients who are in danger of being medical “orphans” if the two entities can’t reach a financial agreement.
These are individuals who do not meet the legal definition of “medically indigent” and, therefore, are not covered under the county’s medical program.
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CHC estimates that as many as 6,000 patients fall into this category, and it’s accusing the county of abandoning these patients by chipping away at its financial commitment to CHC clinics.
Given the economic downturn, county officials say they can no longer afford to fund the clinics at previous levels, and will not be able to pay for patients who don’t meet guidelines for the medically indigent.
Unfortunately, both sides have engaged in blustering and defensiveness that, as Board of Supervisors Chairman Adam Hill recently pointed out in these opinion pages, has generated more heat than light.
The county Board of Supervisors did take a step in the right direction when it instructed staff to continue discussions with CHC. Supervisors also showed a willingness to boost the amount of the contract somewhere closer to $2.5 million, up from its original offer of $2.2 million.
That’s still far short of the $4 million CHC says it needs to continue current levels of service, however.
We can only hope there is some maneuvering room, and that both sides will back away from their entrenched positions.
For its part, CHC does appear to be pointing an accusatory finger at the county, when it has also been hit hard by state and federal cuts. Some acknowledgement of the county’s financial circumstances might help heal this breach.
The county, on the other hand, seems to minimize the consequences of the loss of county revenue and suggests that CHC could easily make up the difference by doing some belt-tightening of its own. The six-figure salaries of some CHC executives are particular targets — including the $292,000 annual salary earned by CEO Ron Castle.
To be fair, there are plenty of county administers who earn six-figure salaries, though granted, none quite as high as $292,000 or the nearly $365,000 earned by another CHC executive.
As far as belt-tightening goes, CHC told The Tribune that is has taken several steps to economize and is in the process of putting other cost-cutting measures in place.
The list of cutbacks includes:
Laying off 24 employees in April.
Negotiating reductions in leases for some of its facilities.
Reducing employee benefits, travel expenses and other operating costs.
Renegotiating contracts with specialists, hospitalists and other heath care providers.
Reducing prescription drug costs through use of pre-packaged medications.
Yet none of that information was shared with the Board of Supervisors last week; Castle said he wasn’t prepared to do so then.
That’s unfortunate — if CHC wants to make a good case for more funding, it should be prepared to talk about the sacrifices it has made.
We don’t believe CHC should be required to justify the purchase of every copy machine and paper clip, but it would be helpful if the nonprofit agency were more open in disclosing its financial situation, and we strongly urge that it do so in the future.
That said, for the moment, the county and CHC must concentrate on salvaging the situation, because a dramatic reduction of clinic services will wind up costing much, much more in the long run.
Sick, uninsured patients who are denied care in clinics will almost certainly wind up in hospital emergency rooms, which are obligated to treat them. That will put a huge strain on emergency rooms and will result in a further escalation of medical bills and insurance rates for patients who are covered.
It makes far more sense — from both a humanitarian and economic standpoint — to provide access to clinics both for preventative care and early treatment of illnesses.
It’s imperative that the county and CHC put their differences aside and approach the situation with openness and an understanding of one another’s financial situation.
Instead of attacking one another, they need to explore every avenue possible that will allow the very successful network of Community Health Center clinics to continue serving all San Luis Obispo County patients who are in need of care, regardless of their financial circumstances.