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Sacramento County Votes To Provide Health Care for Undocumented Adults

The Sacramento County Board of Supervisors this week voted to restore health care services for part of its indigent population, including the undocumented.

The vote came on June 16, the same day legislators approved a state budget that includes funding for full-scope Medi-Cal services for undocumented children, and possibly some adults.

Sacramento County’s decision came two months after Fresno County lawmakers instituted a limited health care policy for its undocumented population. In Sacramento County, the new policy funds care for 3,000 people, a slice of the overall undocumented population in the county.

“What we did … was a small first step,” said Phil Serna, chairman of the county board of supervisors. “We budgeted for 3,000 people and we know for a fact there are tens of thousands of undocumented here. It’s a small segment of a small segment of the [general] population.”

Serna, though, called the unanimous five-person vote “historic.”

“I have to be honest, I thought when it came to the undocumented there might be consternation expressed and there might be reluctance to support it,” he said. “But … what happened is, even the more skeptical members understood the practical aspects of having an entire section of our population not have access to health care services.”

For instance, he said, the cost to the county is high whenever there’s an outbreak of disease like the tuberculosis outbreaks recently experienced in the county.

“If we limit that by making sure people have access to medicine, that they’re treated early and if we’re limiting the spread of that and it doesn’t get to the level of an outbreak, then you would certainly be saving money in a different part of county services,” Serna said.

Sacramento County also has one of the highest rates of chlamydia in the state, and the transmission rate for that disease is high when it goes untreated.

In 2009, Sacramento County tried to eliminate most of its safety net services, and a federal judge in 2010 ordered the county to arrange some kind of indigent care. Most services were handled by federally qualified health centers, Serna said, but delivery of that care had mixed results. The county’s move this week, he said, is designed to ease overuse of emergency departments and hospitals by the adult population within the undocumented population. 

“Regardless of your ideological position on immigration reform, we all understand not just the social reasons why this is important, but why it makes sense for other broader reasons,” Serna said. “It was a confluence of the practical and the ideological.”

At its root, for Serna, it was more about doing the right thing, serving the public health in the county.

“We’re not talking about widgets here, we’re talking about people,” Serna said. “That’s the lens I was looking through — is it good public policy?”

The new systems of care still need to be designed. County supervisors hope to have those systems online by the end of the year.

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