County proposes to cut health care for illegal immigrants and prisoners
By Matt O'Brien
Contra Costa Times
Posted: 03/02/2009 07:23:46 PM PST

In hopes of saving a strained medical system $6 million a year, Contra Costa County health officials have announced a plan to exclude adult illegal immigrants from primary care services.

About 5,500 undocumented immigrants are now eligible users of the county's Basic Health Care Program, which serves low-income residents who cannot obtain any other health insurance.

A plan being presented to the Board of Supervisors this month would make non-urgent county care inaccessible to illegal immigrants, with the exception of children and pregnant women.

Also on the proposed chopping block is a $2.6 million program providing health care for inmates of the West County Detention Facility in Richmond.

"The county doesn't have the money anymore," said Dr. William Walker, the county's health director.

If supervisors approve the plan, the county hospital system would become the second in the state this year to eliminate services for undocumented patients. Last month, Sacramento County supervisors voted to shut off non-urgent care for illegal immigrants in an effort to save $2.4 million.

Walker said Contra Costa would save more than Sacramento did because the clinic system for indigent patients is more extensive here, with 10 clinic locations across the region. The county would continue to provide primary care for undocumented children under age 19 and also provide coverage for emergencies, pregnancies and certain other conditions
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including tuberculosis and breast cancer treatment.

Walker made the announcement Monday through a statement and Podcast posted on the county Web site. A number of local nonprofit health organizations immediately raised concerns.

"We don't think it's good public policy," said Tanir Ami, executive director of the Community Clinic Consortium for Contra Costa and Solano counties. "People stay healthier when their health care is managed."

Ami said her organization and others have begun asking supervisors to reconsider what they cut.

"We think we're about to see 5,500 more patients," she said. "We're not going to be turning anyone away but there may be wait times."

An equally likely but worse scenario, she said, is that those excluded from county care will be discouraged from seeking primary care altogether, endangering the overall health of the community and putting a burden on future emergency services.

Currently, those seeking county medical help typically call a telephone number and go through a financial screening process. Walker said the county would have to put a new system in place to find out whether or not someone is a legal resident of the United States.

"I don't want to deny there could be some increased costs not only for us but for other hospitals," Walker said.

Along with making most illegal immigrants ineligible for county health care, health officials plan to make several other cutbacks to save a total of about $13.5 million. The second largest cutback would eliminate non-emergency health care services at the West County Detention Facility, which houses about 200 women and 600 men. Walker said the county began providing health care at the Richmond facility in 2002 but can no longer afford it.

The county would transfer about 300 to 350 inmates who currently need health care services to the main detention center in Martinez, where health services will continue to be available, he said.

While they will discuss budgetary concerns at their meeting on Tuesday, supervisors are not scheduled to specifically address the planned health cuts until March 17.

Reach Matt O'Brien at 925-977-8463 or mattobrien@bayareanewsgroup.com.
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