Analysis: Fresno County Plan for Low-Income Health Care Too Costly

A Fresno County analysis has concluded that a proposal by Community Medical Centers for a low-income health care program would improve care but cost too much, the Fresno Bee reports (Anderson, Fresno Bee, 11/16).

Background

In September, county supervisors decided that the county could not afford to launch the Low Income Health Program, an optional federal program that would be established at the local level. LIHP is part of California's Bridge to Reform program that aims to expand health insurance coverage until certain federal health reform provisions take effect in 2014.

Counties that set up the program are required to expand services at clinics and access to primary care. The program offers matching federal funds on all local spending.

To set up LIHP, the county would have had to adjust its Medically Indigent Services Program, which is managed by CMC under a contract that does not end for another 15 years (California Healthline, 9/28).

Following the decision not to move forward with implementation of the program, CMC submitted a proposal that would dissolve the hospital system's current contract with the county for indigent health care services and establish LIHP (California Healthline, 10/3).

Under CMC's plan, the county would manage indigent and inmate care and reclaim the $20 million that now goes to CMC to provide that care. The funds would be used to secure matching federal dollars, and the county would pay Medi-Cal rates to CMC for indigent health care. Medi-Cal is California's Medicaid program.

Details of the Analysis

According to the county's analysis, CMC's proposal would improve care for low-income residents but place Fresno County at "substantial financial risk [and] threaten county services."

Edward Moreno -- the county's health director who submitted the analysis -- said the cost of care is more than the $20 million that the county now pays CMC. According to CMC, it spends four times that amount annually to provide indigent care.

Moreno said those costs would shift to the county.

Legal Action Likely

Meanwhile, Chris Schneider -- executive director of Central California Legal Services -- said he plans to sue the county over the board's decision to withdraw the county's application for LIHP (Fresno Bee, 11/16).