MODESTO BEE
ORIGINAL ARTICLE

By KEN CARLSON
BEE STAFF WRITER

Last Updated: September 15, 2005, 04:33:46 AM PDT

Stanislaus County supervisors Tuesday unanimously approved a plan to reduce annual Health Services Agency deficits by serving fewer patients and selling the former county hospital on Scenic Drive in Modesto.

Supervisors said the county can't afford to pay $8 million to $10 million each year to erase the agency's deficits, which are blamed on state and federal health programs that don't cover the costs of care.

"We agonized over every single recommendation," said Supervisor Ray Simon, who served on a committee that drafted the three-year plan. "It is a national problem. We can't solve it here."

In another action, the board agreed to offer 15 acres at the county public safety center between Modesto and Ceres for a $70million veterans outpatient clinic and nursing home. County officials intend to pitch the site, at Crows Landing and Service roads, to the Department of Veterans Affairs at a meeting in Livermore today.

In justifying the health services cuts, officials said that just $80 million of the county's $797 million budget can be spent at the board's discretion. And about $50 million of that is spent on criminal justice and law enforcement.

The board approved several recommendations for reducing expenditures to the Health Services Agency to $3.57 million a year.

The county clinics will handle 207,000 patient visits a year, down from 260,000 visits and the minimum required to maintain a contract with Doctors Medical Center to provide hospital care for county patients. The county also will:

Sell the former Stanislaus Medical Center property on Scenic Drive and transfer family practice, specialty and urgent care services to other clinics by June 30.

Increase fees for people who pay out of pocket for services. Effective Nov. 1, the fees will be $90 for primary care visits, a $45 increase, and $100 for urgent and specialty care, up from $40. The fees do not apply to Medi-Cal patients or the county indigent program.

Prohibit illegal immigrant adults from the county's indigent health program. Undocumented adults will have to pay the clinic fees or seek care elsewhere.

Apply to the state and federal governments for additional funding for clinics.

Preserve the county residency program used to train doctors and recruit physicians to the area.

Set an Oct. 18 public hearing on eliminating mammography and dental services.

Remodel the West Modesto Community Center to accommodate services moved from the Scenic Drive complex. Offices used by the Community Services Agency, the Women, Infants and Children program and other programs will have to move, but the county will try to relocate the offices in west Modesto.

The deficit-reduction strategy met with opposition from a half dozen speakers at Tuesday's board meeting.

Socorro Arriola of Modesto predicted that Golden Valley Health Centers and the few other agencies that serve the uninsured will be overwhelmed with patients.

Other speakers said the new fees are too high for low-income families, and that it's wrong to deny services to people who can't afford health insurance.

Dianne Hernandez, president of the grass-roots organization Congregations Building Community, said the county plan protects the jobs of county employees at the expense of patient services. Only temporary and part-time positions are expected to be cut, although some HSA employees could be reassigned to other county departments.

James Costello, who served as a county clinic physician before going into private practice, urged the board to continue services for undocumented workers. He contended that preventive services such as mammography could save a young field worker from breast cancer.

County staff said that a combination of private payers and Medi-Cal and Medicare patients will have to seek care at other facilities. The options include federally funded clinics such as Golden Valley Health Centers, rural health clinics in Oakdale and Riverbank, and the county's Hughson Medical Office. The Hughson office receives higher reimbursements than other county clinics.

Area hospitals also expect to see more patients in their emergency rooms.

Loss calculations questioned

Samantha Phillips-Bland, director of Stanislaus County fam-ily planning and a clinic employee, questioned the accounting used in calculating the Health Services Agency losses. For example, the county chief executive office charged the agency close to $4.5 million for internal services such as payroll, purchasing, building maintenance, auditing and chief executive office support.

Phillips-Bland, saying she was off duty and speaking as a county resident, urged the CEO's office to come up with a more accurate figure. Assistant Executive Officer Stan Risen said later Tuesday that the charge includes $1.69 million for malpractice and workers compensation insurance and $2.8 million for support from other departments.

Supervisor Bill O'Brien said he wanted more information on costs of demolishing the Scenic Drive complex, finding a home for public health, Behavioral Health and Recovery Services and remodeling other clinics.

Tuesday's decision calls for county staff to prepare a facilities plan and bring it back for board review. The county has budgeted for $800,000 in remodeling costs this fiscal year and more in the future, but selling the Scenic Drive complex is unlikely to cover costs of new facilities, officials have said.

Bee staff writer Ken Carlson can be reached at 578-2321 or kcarlson@modbee.com