The program is part of a transition plan to move into the new federal health care programs that take effect in 2014. But the Board of Supervisors withdrew its application for the Low-Income Health Program because of many unknowns. The decision came down in a divided vote at a meeting that at times got hostile.
"You're doing it in a way that's inefficient," said Supervisor Susan Anderson. Board members got involved in several heated exchanges with community health representatives over a federal program that would expand health care to the indigent.
"Any time you can talk or there's opportunity, you want to keep talking. I think by us withdrawing this application, we absolutely stop that," said Supervisor Henry Perea.
Supervisors discussed whether to withdraw its application to the Low-Income Health Insurance Program because the financial risks are too great. "After several discussions it became apparent that with the limited money we have in Fresno County to spend on indigent care, the financial risk really exceeded our ability and our capacity with local resources to take on that financial risk," said Dr. Edward Moreno, director for the Fresno County Health Department.
The county is currently contractually obligated to pay $20 million a year to Community Medical Centers to provide care to the poor. But that money is not enough to care for all those in need.
"Community has taken on all of the risk. We're paying $80 million right now for that $20 million and you're asking us to take on more risk," said Steve Walter with Community Medical Centers.
A financial burden that the hospital does not want to be held responsible. Those risks include a possible oversight administrative fee the county would have to pay to the state, estimated to be close to half a million dollars. Plus additional expenditures to sustain two programs for those living in poverty.
"If we do nothing and stay where we are, maybe it's not as efficient as some would like. But our indigent are getting the care and it would not be interrupted in any which way," said Supervisor Debbie Poochigian.
But community members voiced their opposition to the Board's consideration.
"I believe it's premature to withdraw this application before we know all factors, before we bring the entire community in for a discussion," said Rev. Sophia DeWitt.
The bottom line, the financial risks proved to be too much for a county already strapped for cash.
Even though the county voted not to participate in the program, its current plan to provide health insurance to the poor will remain intact. It's a plan that now serves roughly 6,000 people a month.