Letters to the Editor

Viewpoint: Providing medical care to the most needy

The recent debate over county funding of Community Health Centers of the Central Coast was a result of the county’s extreme frustration with CHC.

Successful partnering requires mutual trust and cooperation, and recent tactics used by CHC — including threats of closing clinics, reducing services and failing to provide adequate financial and service data to the county — do not exhibit cooperation or instill trust.

The county remains committed to helping provide the best possible medical care to county residents without insurance or the ability to pay. Many people seeking medical attention are eligible for state and/or federal programs but are not enrolled. The Department of Social Services will dedicate two staff members to help enroll eligible patients in programs that will cover their medical costs.

We will continue to work with CHC to create a more workable partnership that ensures all county residents receive essential medical care. However, at a time when the county has to make difficult decisions among competing needs, it is critical that the county understands where its funding is going.

The county spends more than $7 million annually to provide medical care to low-income, uninsured adults, including a limited scope health care safety net program, known as the County Medical Services Program. CMSP is a legally mandated program to provide medical care to low-income uninsured, medically needy adults, expanding upon existing state and federal public insurance programs: Medi-Cal and Medicare. The majority of these funds are from the county’s general fund, which are discretionary. Additional non-discretionary funds like tobacco settlement and court fines also contribute to the health care safety net. In total, these funds are provided to hospitals, medical specialists and to CHC.

The county’s partnership with CHC began with the closure of General Hospital. The county contracted with CHC to assume operations for the county’s primary care clinics, a decision that has greatly benefitted county residents, allocated county tax dollars more efficiently and enabled CHC to grow as an organization. The initial contract with CHC was for $4.65 million, an amount sufficient to provide both robust care to the county’s CMSP patient population as well as other uninsured adults.

With that initial infusion of funding and ongoing annual allocations, CHC was able to (1) provide medical services to CMSP and other patients and (2) increase the number of clinics and expand services. This contributed to substantial growth in CHC’s unrestricted net assets to about $11 million currently. This growth trend has now ended, in the fourth year of the Great Recession, due to decreases in county funding as well as state and federal funding.

This year’s proposed allocation of $2.2 million in county general fund support to CHC is intended to pay for primary care, some specialty and ancillary care and prescription medication services rendered to the CMSP patients. This allocation represents approximately 3 percent of CHC’s annual budget.

As previously stated, we will continue to work with CHC to create a more workable partnership that ensures all county residents receive essential medical care. Toward this end, the county has focused on defining the actual cost for the care of CMSP clients, as distinct from the cost for other uninsured adults. We are moving in that direction, but more data and transparency are needed from CHC.

At a June 15 hearing, the Board of Supervisors approved the recommended $2.2 million allocation to CHC and directed staff to continue to negotiate with them. The county is at the table, we invite CHC to join us.

Jim Patterson represents District 5 on the county Board of Supervisors.

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