Modesto Bee Article
By Ken Carlson, Staff Reporter
last updated March 2, 2008 at 3:40:11 AM
Uninsured adults covered by a county health program will have limited dental and mental health benefits under the latest cost-cutting proposal from the Stanislaus County Health Services Agency.
The plan would limit dental benefits in the Medically Indigent Adult program to $1,000 a year. In addition, the agency would formally exclude mental health and substance abuse services from the MIA program.
The program provides health services for adults meeting the income guidelines. The Board of Supervisors has set a 6:35 p.m. hearing March 18 to consider the cuts.
The Health Services Agency is trying to deal with a shortfall in its 2007-08 budget. If approved, the service cuts will take effect May 1, shaving $98,000 in expenses by the June 30 end of the fiscal year, officials said.
The reductions are expected to save $587,000 annually.
With more patients using dental serv-ices, the agency was faced with spending $1.6 million on such care this year, an increase of $300,000 over 2006-07.
The agency intends to impose a $1,000 benefit ceiling that officials said is common in the private insurance market. There previously was no cap.
According to a county report, about 1,900 of the 6,100 MIA eligible patients seek dental care, and for 23 percent of those patients, the annual dental costs have exceeded $1,000.
Because there is a shortage of psychiatric services locally, county health clinics also have received a growing number of requests to treat serious mental health problems.
The MIA program does not provide mental health services, but county clinic physicians have prescribed drugs to treat mental disorders in patients who also have medical issues and renewed prescriptions for psychotropic drugs that initially were written by a psychiatrist, said Mary Ann Lee, county health services director.
The county pharmacy has filled the prescriptions, costing the agency about $872,000 a year.
"If there is a shortage of coverage for psychiatric issues, it shouldn't mean that our primary care doctors pick that up," Lee said. "It's outside our scope of services."
Under the proposed policy, the clinics still will attempt to assist MIA patients with mental health issues on a private pay basis, if a psychiatrist is involved in the case. Agency staff will apply to obtain free drugs for the patients through pharmaceutical company programs.
The Health Services Agency has made progress in dealing with the financial shortfall for 2007-08, which stood at $12.6 million going into the year after the county contributed $4.4 million in general funds. The agency eliminated certain ancillary services, and a government decision last fall to convert its primary care clinics to federally qualified health centers has boosted reimbursements for Medi-Cal and Medicare patient visits.
Lee said the measures didn't come soon enough to eliminate the shortfall. The agency will need no more than $4.3 million in additional general fund contributions to balance the current budget, she said.
The public hearing will be at 6:35 p.m. March 18 in the Board of Supervisors chambers at Tenth Street Place, 1010 10th St., Modesto.
Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.
