Monday, June 15, 2009

budget cuts



For Immediate Release                                                                                                      Media Contact: Cynthia Carmona

June 15, 2009 10:00 am                                                                                                                                  (213) 201-6518



You Are Cutting Us: Clinic Providers and Patients Decry Budget Cuts

Past Cuts, New Proposals and Possible Payment Delays Cut Clinics to the Bone

Los Angeles—Clinic administrators, doctors and patients, along with LA County Supervisor Zev Yaroslavsky and other partners, expressed their dismay over the current crisis and called on Sacramento to expand their budget agreement to include more than just cuts to the working poor.

“These cuts hurt clinics. These cuts hurt patients. The latest proposals, in addition to the enacted cuts and pending payment delays will push clinics past the breaking point,” Gloria Rodriguez, President and CEO of the Community Clinic Association of LA County, stated. “Our leaders must take fair, decisive action that protects our most vulnerable during these difficult times and includes revenue as part of the solution.”


Community clinics face cuts to a variety of programs that help them keep their doors open to all who are seeking health care services. One program slated for elimination, the Expanded Access to Primary Care (EAPC) program, funded over 56,000 patient visits in LA County in 2007. Clinics also serve some of the over 233,000 LA County children enrolled in the Healthy Families Program, also slated for elimination. The Medi-Cal program, targeted for additional cuts, makes up 31% of clinic funding in LA County. Other cuts to services including family planning services and HIV/AIDS programs will further chip away at clinics and the communities they serve.


“These cuts could result in over 2 million Californians, including about 1.5 million children, losing health coverage—and cut billions from our economy, and the health system we all rely on." said Anthony Wright, Executive Director at Health Access California, the statewide health care consumer advocacy coalition. "Such a giant step backward would demolish years of progress and go in the opposite direction of President Obama's health care reform. There are better choices for California. The Governor and the Legislature should examine all possibilities—including raising the revenues and taxes needed to prevent these cuts.”

The Governor’s proposals come on top of the July 1 elimination of Medi-Cal optional benefits, which include adult dental services, podiatry and optometry. LA’s community clinics provided over 280,000 dental visits in 2007—many will be unable to sustain a dental practice without an adult Medi-Cal payer source. On Friday a Sacramento court heard arguments over whether the state can, in fact, deny payment for these benefits to a category of clinics known as federally qualified health centers.


With the state’s cash flow in crisis as well, community clinics also face payment delays that could stretch into November. LA’s community clinics endured an 85-day Medi-Cal delay during last year’s budget standoff, at a cost of $3.85 million per week. This year, delays are expected to go on longer, and many clinics’ drained reserves will be unable to sustain them for such a long interruption. To withstand the payment delays, many clinics must consider laying off employees, delaying the hiring of badly-needed doctors, or reducing their hours of operation.


The cuts will have a far reaching impact on the County’s ailing health system, reducing patient access and driving up demand for already-crowded hospital emergency rooms.


Jim Lott of the Hospital Association of Southern California (HASC) also weighed in on what the Governor’s proposals would mean for LA County.  “These cuts will inflict wounds that won’t heal,” Lott said.  “More seniors will be sent to nursing homes, and our safety net clinics and hospital emergency rooms will break under the strain of increased demand and lack of resources.”


LA County is also hurt dramatically by these cuts: current estimates put the impact of the cuts to the County’s budget at $1.5 billion through June 30, 2010. From cuts to Medi-Cal’s health services to CalWORKS’ assistance for the poor, the County will be hard-pressed to serve its neediest. LA County Supervisor Zev Yaroslavsky stated, “the Governor’s recent proposal not only goes after state-funded health programs but local funding as well, leaving our health providers and their patients nowhere to turn. We know that fiscal prudence is called for, but the current proposal pushes LA County’s health system to the brink of collapse.”


The legislative Budget Conference Committee has already begun voting on the proposals and community clinic patients, staff and their supporters continue to pressure leaders to salvage essential services. All of this is taking place at a time when the Obama Administration is pushing for health care reform. It is unclear how such broad cuts would hinder any reform efforts.


Congresswoman Lucille Roybal-Allard (CA-34) conveyed her concern over how the Governor’s plans would affect access to health services. “At the very time we are focused as a nation on expanding access to quality health care, I am extremely concerned about jeopardizing one of the most important access points for our most vulnerable Californians.  Community clinics are a critical part of the county’s public health infrastructure, and to the extent their services are diminished, all of us pay a price with respect to the health and wellness of our families,” Congresswoman Lucille Roybal-Allard (CA-34) said.


Clinics and other health care advocates will continue to increase the pressure on elected officials until the crisis is resolved. “This system cannot sustain these cuts and we will continue to fight for the patients that clinics serve,” Rodriguez says. “It is time that the Governor and the Legislature take responsible action and provide a balanced solution that does not let Californians down when they need help the most.”


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THE COMMUNITY CLINIC ASSOCIATION OF LOS ANGELES COUNTY (CCALAC) is the largest regional association of nonprofit community and free clinics in California.  Founded in 1994, CCALAC has 42 members that operate more than 120 clinics throughout the county.  These clinics serve nearly one million patients per year, the majority of whom are uninsured or underinsured.  CCALAC is dedicated to serving and representing the interests of its member clinics as providers of quality health care, including medical, dental and pharmacy services.


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