North Bay clinics brace for cuts as state’s stimulus may come in low

NORTH BAY – North Bay community clinic leaders said they expect California budget leaders to “pull the trigger” on further Medi-Cal cuts this Wednesday, putting dental, mental and other services at risk of closing for the state’s poorest.

“We are extremely nervous. We are already stretching our family practice doctors hugely, and if they eliminate funding for the few specialists we do have – like in mental health, podiatry – it will only make it even harder,” said north Sonoma County’s Alliance Medical Center Chief Executive Jack Neureuter.

With the California budget resolution, legislators included a list of further cuts that would only activate if the state did not receive at least $10 billion in direct budgetary relief as part of the $50 billion expected to flow into California from the stimulus. The state Treasury said it would announce its decision on the trigger by April 1, but initial calculations posted on its Web site as of Thursday show the stimulus just missing the mark.

Among the $1 billion in cuts, the state would eliminate about $130 million of “optional benefits” from Medi-Cal, which includes adult dental health, mental health, optometry and other specialty services. Mr. Nuereter said Alliance in Healdsburg would lose about 30 percent of its dental program revenue. He projects the clinic would only be able to sustain the program until summer.

“We haven’t really decided what to do yet. Up until now when we realized the cuts are probably going through, we’ve kind of had our head in the sand like an ostrich,” he said.

Clinic executives said their best defense will be beefing up the children’s programs, which will still provide revenue, but inevitably some services will be severely reduced or closed. Others said they will likely resort to layoffs or pay reductions in order to hang on to the programs. Napa-based Clinic Ole Executive Director Beatrice Bostick said the center could lose as much as $500,000 in revenue.

“Our dental department is about 50 percent adults. It will be a huge loss for us,” she said. “We figure that about two-thirds of our adult patients will go back to neglecting serious issues and end up in the emergency room. … Not paying for adult dental just cost-shifts the burden from the clinics to the ER, where everything costs 10 times more.”

A spokesman for the statewide clinic advocacy group California Primary Care Association said it became apparent in just the last two weeks that the state would implement the cuts.

“I would say in the past 10 days it really became apparent that this would happen. Through most of March, we were operating under the fact that would thought we would get enough from the stimulus,” said CPCA spokesman Chris Patterson. “Right now we are preparing for the worst.”

A spokesman for the Redwood Community Health Coalition, which represents about 14 centers in the North Bay, said local leaders advocated in Washington last week to see if federally qualified providers could be exempt from the cuts.

On the bright side, the coalition estimates that five North Bay clinics, including Southwest Community Health Center, Petaluma Health Center, Sonoma Valley Community Health Center, West County Health Centers and Alliance Medical Center, will receive an additional million dollars from the health provisions in the stimulus.