Medi-Cal rate cuts felt statewide

Just as Bobby Peterson's family struggles to find a recovery facility to accept the 21-year-old stroke victim, the climate for Medi-Cal patients and providers is worsening in California.

Starting Tuesday, the state is paying 10 percent less in reimbursements to Medi-Cal and Denti-Cal providers, and California already had the lowest reimbursement rates in the nation.

"It affects all of us, it affects the quality we all receive," said Anthony Wright, executive director of Health Access California, a nonprofit health-care consumer advocacy coalition. "We all use the same health-care system."

The cuts were approved by the Legislature in February as part of Gov. Arnold Schwarzenegger's plan to shrink a $15 billion budget deficit.

Medi-Cal, California's version of the federal Medicaid program, covers 6.6 million low-income people, more than half of whom are children, Wright said.

In the state's current budget of about $100 billion, Medi-Cal and Health and Human Services, at $13.5 billion, are the state's second-largest expenditure after education.

Because Medi-Cal is such a significant portion of the state's spending, taking it off the table for cuts is not an option, said H.D. Palmer, a Schwarzenegger spokesman.

"The proposed reductions speak to the severity of this budget crisis," he said. "That is why the governor had to propose it, and the Legislature has already adopted some difficult decisions in the Medi-Cal area."

The cut to reimbursement rates sparked a lawsuit by groups, including the California Medical Association, California Hospital Association and California Dental Association. A hearing demanding a stop to the cuts is scheduled for July 25 in Los Angeles.

"It matters to every single Californian because what is going to happen if doctors and pharmacists stop seeing Medi-Cal patients, those patients are going to start showing up at ERs," said Jan Emerson, spokeswoman for the California Hospital Association.

"You are just going to add that much more to the already overcrowded situation in ERs because these patients now have nowhere else to turn."

The wrangling over Medi-Cal is not limited to reimbursements and is far from over.

Lawmakers are now officially late in crafting and approving the 2008-2009 fiscal plan for the state. Still on the table are proposals to cut speech therapy, podiatry, psychiatry and optometry from therapies and services funded by Medi-Cal.

For Bobby Peterson, the impact is immediate and severe.

Currently, Peterson, who is a Medi-Cal recipient, is working with speech therapists who are not only teaching him to communicate without his voice, they are also helping him re-learn how to swallow.

"He had a stroke, which affects the speech center and swallowing center and his ability to think and process information," said Corby Kessler, Peterson's rehabilitation doctor at Queen of the Valley Medical Center in Napa. "Speech therapy deals with those three areas."

Peterson has a feeding tube surgically implanted into his side because he is unable to swallow enough food to meet his nutritional needs. It cannot be removed until he re-learns how to swallow.

He is currently eating apple sauce and pudding half-teaspoons at a time.

"He is continuing to make gains, but they are slow gains," Kessler said. "He needs continued therapies to bring about as much as you can."

You can reach Staff Writer Kerry Benefield at 526-8671 or kerry.benefield@pressdemocrat.com.