Open Door will be less so after cuts

From the April 22, 008 issue

By Daniel Mintz
Press Staff Writer

State budget cuts will fall hard on health care, and community clinics are bracing for Medi-Cal losses that will force them to reduce services –

a turnabout that could affect residents of all income levels.

The potentially drastic effects of Medi-Cal cuts and payment delays were described at the Tuesday, April 15, Board of Supervisors meeting by Herman Spetzler, CEO of the Open Door Community Health Center and board chairman of the North Coast Clinics Network. After mentioning the “inevitable cuts” coming in the next fiscal year – Governor Arnold Schwarzenegger has already approved a 10 percent Medi-Cal funding cut – Spetzler requested that supervisors create a task force to provide “some help with deciding, as we have to deal with limited resources, on who it is we’re not going to provide care to.”


The state’s budget deficit could top $20 billion and Medi-Cal funding is one of many targets for spending cuts. Delay of some payments has also been approved, and Spetzler’

s Open Door facilities in Arcata, McKinleyville and Eureka will deal with both cuts and cash flow problems. 

Open Door will lose funding at a time when local health care is struggling to meet demand on all levels. The county’s Open Door clinics treated 22,000 patients last year, said Spetzler, adding that 7,000 of them were new –

those who can afford health care but chose Open Door because there are limited options here. 

“The deterioration of the private sector, primary care side is a fundamentally dangerous aspect of what’s happening in our community,” Spetzler said. “Access to health care in our community is in a perilous time.”


Open Door has expanded its hours into evenings and Saturdays, Spetzler continued, and “we still are turning away hundreds of people all the time.” He gave supervisors a heads up on an emerging and troubling trend. “I don’t know whether you’ve heard about the difficulty in the emergency rooms, but people are waiting two-and-a-half to five hours in the emergency rooms for services they shouldn’t even be getting in an emergency room in the first place,” he said. “That’s because we’re at capacity.”


And Medi-Cal cuts will reduce Open Door’

s total budget, much of which pays for staff. 

“We don’t have the ability to absorb any reduction in resources without it impacting staff,”

Spetlzer said. Creation of a task force will allow the county and health clinic directors to work as a team when health care funding gets tight and difficult decisions need to be made, he continued. 

“How do we bridge that, how do we make the decisions on who doesn’t get access?” said Spetzler. “And what do we do as we overburden our emergency room system?”


Supervisors voted to create the task force, which will include supervisors Bonnie Neely and John Woolley, county staff and health clinic directors. Woolley is a member of the Community Health Alliance, which is working on improving local health care resources, and he asked if it could help. Spetzler said it could, but he believes “a smaller group that actually deals with numbers”

is best. 

“When things get really complex, the moral issue becomes, do you see those who need the care the most?”

he asked, explaining that if some privately-insured patients have the most intense need for services, they could displace those who are subsidized by Medi-Cal and the county, sending them into emergency rooms. 


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