Supervisor Henry Perea says that Fresno County’s decades-long contract with a local hospital to provide medical care to indigent patients could soon come to end.
“I think in the very near future, we just may be ending the contract with Community Hospitals, and going a different direction on the health care piece of it,” says Perea.
Perea was speaking on Valley Public Radio’s Valley Edition.
The potential change is part of the seismic shifts in the health care delivery system brought about by the Affordable Care Act, and the question of just who will now be responsible for care for one group that's not covered by the law - undocumented immigrants.
"I'm very concerned about the fact that there is a hole now for the undocumented care in Fresno County," says Perea.
The possible change is being driven by the state's move to redirect $7 million in health care funding from the county to the state to help pay for expanded Medi-Cal coverage. Many low income residents who received care from the county through Community will now be eligible for Medi-Cal. But around 6,000 county residents will remain uncovered, many of whom are in the country illegally.
Perea says the county is looking at ways that it can continue to provide care for those who remain uninsured, such as contracting with local clinics.
"I think what we’re looking is with the changing economics of the dollars that are coming in or being diverted to the state under different programs, is there some way that we can capture a portion of those funds to provide that care for the undocumented? Then the question would be, with the other clinic systems that we do have in operation in Fresno County, contracting with them to provide that care, that’s what I would see happening," says Perea.
The county's 30-year contract with Community to provide indigent care though the MISP program dates back to 1996. Under the agreement the county pays Community a flat $20 million fee to provide the care. Community's contract also covers health care services for the county's jail inmates and juvenile offenders.
Community says it costs far more to provide the care than it receives in payments from the county. In the 2011/2012 fiscal year, the hospital says the indigent program had a shortfall of over $62 million.