Española Valley health care providers are watching and waiting to see whether a proposed redesign of the state’s medical assistance programs is adopted that could strain budgets and even close one organization entirely is circulated around the state.
The state Human Services Department is planning a redesign of its medical assistance programs in the face of a projected $322 million revenue shortfall, Department spokeswoman Betina McCracken said. Though the redesign is still in very preliminary stages, the Department is currently discussing limiting its Medicaid program to only mandatory services under Federal law and requiring co-payments for its State Coverage Insurance, among other changes (see related story).
These changes will almost certainly affect most Valley health care providers, according to their representatives. Ayudantes, the former state-sanctioned mental health clinic for Rio Arriba County was replaced by Presbyterian Medical Services last month, but is continuing to operate out of its new location in old Española Valley Chamber of Commerce building in Española.
Ayudantes Executive Director Violanda Nunez said the clinic could still serve patients whose services are covered by Medicaid, meaning the clinic could still get federal funding for those services.
However, one of the optional services that may be removed from the proposed Medicaid Service Plan is clinic services, according to Department documents. Specifically a list released by the Department lists “intensive outpatient substance abuse services” as an example of a clinic service. Psychiatric services for Medicaid populations are also on the list.
Though these two services form the core of Ayudantes’ offerings Nunez said she had no idea the Medicaid redesign was even being discussed.
Other health care providers had heard about the redesign, but are waiting for the outcome of the upcoming state legislative session to plan for the future.
El Centro Family Health, which serves low-income patients, gets some federal and state funding of its own, Chief Executive Officer Lore Pease said.
“We’re waiting to see what the result of the session will be,” she said. “But we do get federal and state funding to see under-served patients so if they’re touched by the Medicaid changes, I’m waiting to see how that will reciprocate on our federal grant monies.”
Because of El Centro’s funding situation, Pease said she is concerned about the potential impact on her patients more than the impact on her organization.
“I am contacting all my representatives and I am encouraging them to please, please continue to support health care,” she said. “If a citizen’s unemployed, they won’t be able to afford even a $10, $15 co-pay.”
Presbyterian Healthcare Services runs Española Hospital as well as a number of other non-profit hospitals around the state. Presbyterian spokesperson Todd Sandman said he sympathizes with the Department’s goal of working within their means to provide for residents, but he also realizes it will mean his organization will have to make some sacrifices.
“Every time benefits are scaled back you worry that there will be more people who can’t afford their bills for the services you do provide,” he said.
In those cases, Presbyterian hospitals, like Española Hospital, foot bills out of their indigent funding program. Some of that funding is covered by the state, but at least some of that money comes out of the hospital’s budget, he said.
“We know there will probably be an impact on our budget, but we’re waiting to see what actually happens,” he said.