NORTH COUNTY: Lack of state budget affecting local health care providers

Medi-Cal reimbursement checks to hospitals, community clinics are about to stop

By ANDREA MOSS - Staff Writer | Friday, July 25, 2008 11:05 PM PDT ∞

NORTH COUNTY ---- The lack of a state budget is creating financial worries for local health care providers whose Medi-Cal payments have been drying up and are expected to stop altogether next week.

Palomar Medical Center, Tri-City Medical Center and community clinics such as Neighborhood Healthcare, which has offices in several North County cities, are among the medical facilities being forced to find ways to bridge Medi-Cal funding gaps that began growing July 1.

A state and federal health plan for California's poor, Medi-Cal has thousands of elderly, minor and disabled people on its rolls.

Steve Escoboza, president and chief executive officer of the Hospital Association of San Diego and Imperial Counties, said Friday that the funding problem is about to get worse. That's because a $2 billion emergency fund that the state has been using to make some Medi-Cal reimbursement payments is nearly gone.

"That fund was exhausted as of yesterday," Escoboza said. "It actually will exhaust by Monday for those who use electronic fund transfer system. ... After that, there's no money left."

The Medi-Cal payments are not expected to resume until a new budget is approved. Last year, that did not happen until Aug. 21.

If the new budget is delayed too long, Escoboza said, community clinics and smaller hospitals with few financial resources may be forced to limit their services until the checks start coming in again.

"What's going to happen is, these people who get services at these other locales are going to go to emergency rooms," he said. "It just means those emergency departments are going to be flooded."

State law requires California's legislators to adopt a budget by July 1, which also marks the start of the state's fiscal year. However, state lawmakers missed the deadline this year and have yet to agree on a financial plan.

Without a budget, the state is unable to pay many of its bills and pass on much of the money it funnels to cities and other entities, including those that provide health care services to Medi-Cal patients.

Officials with Palomar Pomerado Health, a public health care district that runs Palomar Medical Center in Escondido and Pomerado Hospital in Poway, said it typically receives one Medi-Cal check worth an average of $1 million every week. The state withheld a check in June and told the district to expect just one payment this month and none in August, said Traci Adair, patient financial services director for the district.

Ondrea Labella, director of patient business services for Tri-City Medical Center, said it usually gets weekly Medi-Cal checks as well, though she didn't know the dollar amounts involved. While the district has received all the payments due to it so far, state officials have told Tri-City it will receive no checks after the end of the month, said hospital spokeswoman Courtney Berlin.

Officials at both hospital districts said they probably have enough resources to tide them over until the payments resume, though their interruption could temporarily affect the hospitals' cash flows on paper.

Tracy Ream, CEO of Neighborhood Healthcare, said organizations like hers will be harder hit because they serve large numbers of Medi-Cal patients and have fewer reserve funds and other resources to fall back on. Many community clinics are nonprofit organizations.

"We are fortunate, more fortunate than most health centers, (because) we do have some reserves," said Ream, whose organization gets about 45 percent of its $30 million annual budget from Medi-Cal reimbursements. "But we expect if it keeps going ---- and there's every indication that it will ---- that we will use up our reserves."

She and Escoboza said that the hospital association and others are trying to arrange for local banks and other potential sources of money to extend low-interest loans to health care providers who need help to temporarily bridge the funding gap.

Contact staff writer Andrea Moss at (760) 739-6654 or amoss@nctimes.com.

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12 comment(s)[-]Go to Top

Did you hear this wrote on Jul 26, 2008 6:14 AM:MediCal running out of OUR money!! Illegals go home. Uninsured quit spending your money on Comic-con, Batman and iPhones. Buy insurance Dude or "heal thy self". It's like your body, not mine. Take care of it at your expense.

bj wrote on Jul 26, 2008 7:41 AM:Governor is so dead set on /at any cost to defunct these types of services. Wait until all sort of contagious diseases and deaths, on going illnesses become worst and it cost the state more or people will suffer much more. He is so set on providing the Thousands of prisoners under the three strike laws which are a bunch of prejudiced lies and what is put to the public is different than what is going on in the courts at the prisons and with the inmates. Employees set up disturbances and cruel punishment to the racially locked up. If you pronounce hatred and low living, and doggish and inhuman treatment. What do you expect from humans. Inside and out. He spends so many millions on this system. Takine away from many programs and services that we all use. Including our kids, and parents, and retiring citizens. The prison industry is a money network to the government that serves what their interest is, not ours so much as you are made to panic and feel about the thousands kept at alarming amounts of money per day on an individual, instead of helping and setting up cheaper strict programs for them, and spend many dollars on the needed, and rehabilitate and stop reporting lies about progress and danger, We would not have such a disrupted government. WAKE UP, and stop listening to prejudices to get you to keep voting for the prison issues and scareing the hell out of you. Most of these laws are focused around hate and poverty and prisons. and taking money from you taxes. Check with some of the groups like Civil Liberties, Families against three strikes and other and attorneys and find out how much and why. YET RIGHT HERE IN AMERICA< WE WORRY ABOUT THE IRAQ and other prisoner getting the righteous trials and treatments at alarming expenses.

hoq wrote on Jul 26, 2008 8:31 AM:Why is incarceration a racial issue? Because minorities commit more violent/drug-related crime? Or is that fact not sufficiently politically correct for you?

Escondeeter wrote on Jul 26, 2008 8:45 AM:In a way, it's a blessing in disguise. Legitimate providers will find other sources of income and will generally manage to survive. The entities whose sole source of income comes from defrauding the Medi-Cal system will have to find some other line of work. So you could say these budget delays help cull the herd.

HELP US ARNOLD wrote on Jul 26, 2008 3:27 PM:Gov Arnold, why not take a stand for something that 90% of every legal Califorian wants, ban illegal immigration and secure the border.

Beth wrote on Jul 26, 2008 4:41 PM:I agree with the first comment.

I love it wrote on Jul 26, 2008 6:11 PM:Sometimes it takes a bankruptcy or it's equivalent, to get the fiscally irresponsible to pay attention to finances. Yes folks, "money", it's a finite resource. It's time to rewrite the rules of who is actually entitled to non life threatening health care. I'm beginning to think that a strong economic downturn might be best for us in the long run. San Diego and Imperial counties? No surprise there. Adios

Hey BJ strikes youre out wrote on Jul 27, 2008 1:14 AM:Take your meds and re-read the story. Don't let the clues of which geographical regions that are being taken advantage of escape your eagle eye, either. California was a wealthy state. We just can't afford to absorb all of the non-contributing illegals that believe this is a free for all any longer. It's ironic that poor, working LEGAL Americans can't afford health care and have to go to Mexico to afford a dentist, while the illegals are bankrupting OUR system while taking far more than they contribute. But, you're right we do spend too much on prisoners here. We should take Arizona's lead and house them in tents in the desert.

CITIZEN AT RISK wrote on Jul 27, 2008 9:50 AM:If you thinks health care is full of fraud and costly now, wait till Obama get's in and it's all free

Politicians Play Games wrote on Jul 27, 2008 10:12 AM:Cut off the paychecks to the politicians until they pass a budget and then watch that thing get passed. The problem is that politicians are pretty much insulated from the decisions they make. They are playing hard ball with each other and the rest of us pay the price. Really great job.

..... wrote on Jul 29, 2008 9:58 AM:this is not just hurting clinics but pharmacies as well. if medi-cal goes away, more people are not going to be able to treat their diseases meaning possible epidemics which means more money to fight these. Plus it effects everybodies heatlh. medi-cal is a good thing and its used by people of all race...so dont say its just illegals using the system cause its not.

CITIZEN AT RISK wrote on Jul 29, 2008 10:41 AM:Olga and Obama are the way to go. It will all be FREE!

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