Stanislaus County is notifying the vast majority of adults who receive indigent health services that they need to apply for the state and federal Medi-Cal program.
An estimated 90 percent of the 9,000 who have been served by the county’s medically indigent adult program ((MIA) qualify for Medi-Cal under the expanded eligibility rules of the Affordable Care Act, which take effect Jan. 1. The federal law lifts Medi-Cal’s income limit to 138 percent of the poverty level, and the program will accept childless adults.
The county Health Services Agency will ask supervisors Tuesday to set a Nov. 5 hearing on closing or reducing services used by indigent adults. On the chopping block are the pharmacy and oncology services at the county health services complex on Scenic Drive in Modesto.
In addition, dental care for those who remain in the county indigent program would be reduced to what Medi-Cal provides. The actions are not scheduled for discussion at Tuesday’s county board meeting, but supervisors will consider a consent item for setting the Nov. 5 hearing.
People who have received indigent adult services represent only a small percentage of the 70,000 to 80,000 people served by the county health clinics every year. Other patients are enrolled in Medi-Cal or Medicare, and some have private insurance.
Mary Ann Lee, health services director, said about 94 percent of prescriptions filled at the agency’s pharmacy have been for people in the MIA program because they can’t afford to buy medications from private pharmacies.
Medi-Cal recipients have access to retail pharmacies that contract with the public health program. In the future, the county will contract with private drugstores to fulfill its responsibilities to indigent adults who are not eligible for Medi-Cal, Lee said.
The county pharmacy has served around 5,700 patients a year.
Last year, about 190 patients had visits at the county specialty clinic with two oncologists who contract with the county, including 50 enrolled in the MIA program. Chemotherapy and other cancer treatment has been done at Doctors Medical Center under a county contract.
Patients who remain with the county program will have appointments with the specialists at their local offices. Medi-Cal managed care plans have contracts with oncologists in the community, Lee added.
Patients moving from the MIA program to Medi-Cal will have access to fewer dental services. The state is restoring some Medi-Cal dental benefits for adults in May, after those benefits were mostly eliminated four years ago.
County staff recommends that MIA dental services mirror the restored Medi-Cal benefits. About 200 to 300 patients would be affected if county leaders agree to modify the services in November.
The county will avoid about $2.2 million in annual costs by eliminating its pharmacy. Closing the oncology service will cut about $500,000 from the annual health services budget.
Closing up shop will eliminate jobs for seven pharmacy employees. A report says the county is working with the affected employees to possibly transfer them to vacant health service positions or test for jobs in other county departments.
Bee staff writer Ken Carlson can be reached at email@example.com or (209) 578-2321.