Health care leaders are warning of a looming crisis that will soon destabilize federally subsidized community clinics, punching a hole through a crucial safety net for tens of thousands of Latino and immigrant families in Sonoma County.<\/p>\n
The biggest blows to local community clinic funding will come from President Donald Trump\u2019s cuts to the federal Medicaid program under his One Big Beautiful Bill and the expiration of Obamacare subsidies, according to Francisco J. Silva, CEO of the California Primary Care Association, which represents more than 2,300 community health centers and clinics.<\/p>\n
Silva, who was the keynote speaker Friday at the monthly luncheon of local Latino leadership group Los Cien, said those two seismic fiscal shifts will result in a $30 billion blow to Medi-Cal, the state\u2019s version of Medicaid, with an estimated 1 million to 3 million Californians losing health coverage, even as another 400,000 residents are priced out of the state\u2019s Covered California health exchange.<\/p>\n
Silva pointed out that across the state, Latinos represent 54% of community health centers\u2019 6.2 million patients. Nearly 40% speak limited English and more than half live below the federal poverty level. A quarter of all Medi-Cal beneficiaries receive their primary care at a community clinic, and Latinos make up the largest share of the state\u2019s Medi-Cal enrollees, he said.<\/p>\n
\u201cSo let\u2019s be direct \u2026 a cut to community health centers is a cut to the Latino community,\u201d Silva said. \u201cA threat to community health centers is a threat to Latino health, Latino families and Latino futures.\u201d<\/p>\n
Federal Medicaid policy changes include cuts to spending, work requirements, more frequent re-enrollment requirements and greater eligibility restrictions for some immigrants lawfully in the country. Meanwhile, state changes to Medi-Cal include cutting or limiting benefits to undocumented immigrants, freezing enrollment and cutting long-term care and non-emergency dental care.<\/p>\n
\u201cWe are at the intersection of major federal policy changes, state level shifts in Medi-Cal, rising uninsured rates and significant pressure on community health centers,\u201d Silva said. \u201cThis is not one challenge. It\u2019s a convergence of a lot of challenges and Latino communities are at the very center of it.\u201d<\/p>\n
The Los Cien event Friday featured a panel discussion with key local health care leaders, including the CEOs of the county\u2019s two largest community clinic consortiums: Pedro Toledo, CEO of Petaluma Health Center, and Gabriela Bernal-Leroi, CEO of Santa Rosa Community Health, which together have a roster of close to 90,000 patients.<\/p>\n
The panel also included Nolan Sullivan, director of the Sonoma County Department of Health Services; Dr. Patricia Hiserote, program director of the Kaiser Permanente Family Medicine Residency; and Donna Waldman, executive director of the Jewish Community Free Clinic.<\/p>\n
Hiserote said the looming federal and state changes to Medi-Cal funding will be a blow to the county\u2019s \u201cstrong foundations of health,\u201d where low-income residents and the most vulnerable are the first to feel the brunt. But she said inevitably, the broader community will be impacted.<\/p>\n
\u201cThose with means can last a little bit longer,\u201d she said. \u201cBut make no doubt about it, these changes will affect everyone and truly change the fabric of our community, which is why it\u2019s so important that we\u2019re having these conversations and bringing our people together.\u201d<\/p>\n
Bernal-Leroi said the expansion of Medi-Cal, one of the key components of the Affordable Care Act, allowed Santa Rosa Community Health to make \u201cgreat strides\u201d in caring for adults with chronic illnesses. \u201cNow this is really sending us back,\u201d she said.<\/p>\n
Waldman said the loss of health insurance for so many people will likely result in a dramatic increase in the volume of patients seeking care at the Jewish Community Free Clinic.<\/p>\n
The clinic, which depends on the volunteer help of close to 100 physicians, nurse practitioners and other medical staff, is the only free health center south of Chico, west of Sacramento and north of Marin County, Waldman said. Like other free clinics, it isn\u2019t meant to provide long-term care for large numbers of patients, she said.<\/p>\n
She said federal and state health care changes will result in an estimated sixfold increase in the number of uninsured patients who receive care at the clinic, from 2,500 to 15,000 people.<\/p>\n
\u201cIt\u2019s not necessarily realistic and it\u2019s already started happening,\u201d Waldman said. \u201cWe\u2019ve seen a 25% increase just in the past 60 days, as we begin to build capacity. So it\u2019s going to be very tricky.\u201d<\/p>\n
Waldman said she wakes up \u201cin the middle of the night, because how are we going to do this?\u201d<\/p>\n
Toledo, of the Petaluma Health Center, said the changes are creating a level of anxiety and fear, particularly among immigrants and their children, that he hasn\u2019t seen in decades.<\/p>\n
\u201cWe just don\u2019t have the capacity at this point to meet the needs of the community,\u201d he said.<\/p>\n
Sullivan, the county health services director, said some of the changes to Medicaid eligibility will saddle county staff with greater workloads, further complicating local Medi-Cal enrollment. He said hundreds of county workers who conduct Medi-Cal recertifications for clients every 12 months will now have to do so every six months.<\/p>\n
\u201cBy dropping the recertification period for most Medi-Cal recipients from 12 months to six months, you essentially double the workload of the county,\u201d Sullivan said.<\/p>\n
Sullivan said the changes will also exacerbate a pattern known as \u201cchurn,\u201d where people are disenrolled for various reasons during Medi-Cal renewal or recertification periods. New Medi-Cal work requirements, which have not been used in decades, he said, will also result in additional processing work for county staff.<\/p>\n
\u201cI know many of you are already sort of frustrated with the county service when it comes to processing Medi-Cal,\u201d Sullivan said. \u201cI know we get behind, I know our phone wait times can be long. We\u2019re trying our best. This is going to dramatically, dramatically hinder that problem. \u201d<\/p>\n
Sullivan also pointed out that Medi-Cal is reimbursed based on caseload, even as caseloads are expected to go down.<\/p>\n
Sullivan, who described himself as an optimist, nevertheless provided some of the most sobering comments during the event. He said federal and state dollars, which in previous decades have been a reliable funding source, can no longer be counted on.<\/p>\n
Local initiatives, such as Measure O funding for behavioral health services, as well as large contributions from local donors and health care providers, will become increasingly important to blunt the impact of withering state and federal support.<\/p>\n
\u201cNo matter who you are or what organization you work for, you will be impacted by this in some way, shape or form,\u201d he said, adding that the loss of health coverage for the most vulnerable will have wider repercussions.<\/p>\n
You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressfish.<\/p>\n","protected":false},"excerpt":{"rendered":"Health care leaders are warning of a looming crisis that will soon destabilize federally subsidized community clinics, punching…\n","protected":false},"author":3,"featured_media":387934,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[175902,210,1141,1142,18487,3170,9703,77435,67,132,68],"class_list":{"0":"post-387933","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-covered-california","9":"tag-health","10":"tag-health-care","11":"tag-healthcare","12":"tag-medi-cal","13":"tag-medicaid","14":"tag-one-big-beautiful-bill","15":"tag-trump-cuts","16":"tag-united-states","17":"tag-unitedstates","18":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115571656240634830","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/387933","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=387933"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/387933\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/387934"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=387933"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=387933"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=387933"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}