EDITORIAL: Fresno County public health put at risk by Brown's plan

Budget proposal would cut state aid to care for indigent.

FresnoJune 5, 2013 


Gov. Jerry Brown is seeking to keep a lion's share of state money that previously went to counties or public health and indigent care.


A proposal in Gov. Jerry Brown's budget could endanger public health in Fresno County.

In a nutshell, the governor wants the state to take back the bulk of a $1.5 billion block grant that goes to counties for the medically indigent and for public health.

Brown's thinking is that under federal health care reform, many of the uninsured who rely on county care will be covered after Jan. 1 under an expanded Medi-Cal paid for by federal dollars or in the exchange of private insurers with federal subsidies. Thus, counties won't need as much money for the medically indigent.

The problem with the governor's plan is that while the Medi-Cal expansion will cover many of the uninsured that counties now serve, it won't cover everyone.

More specifically: For Fresno County, the change would drastically reduce state money the county uses for indigent medical services contracted through Community Regional Medical Center.

Under the county's contract with Community, it pays $20.7 million a year for indigent care. According to Fresno County Administrative Officer John Navarrette, the county could lose as much as $8 million in state aid toward that contract if Brown's plan is approved without modification.

As the June 15 budget deadline approaches, the governor's proposal must be adjusted to reflect the realities that Fresno County and the 57 other counties deal with in providing indigent medical care and protecting public health.

Senate President Pro Tem Darrell Steinberg, D-Sacramento, and Assembly Speaker John A. Perez, D-Los Angeles, need to step up and, in concert with other lawmakers, come up with a real-world solution.

Protecting public health is a basic government function. County health officers track illnesses and deaths from West Nile virus to hospital infections to food-borne contamination. They conduct vaccination campaigns and restaurant inspections. They respond to outbreaks and disasters.

If Brown sweeps the bulk of the funds, counties will have to choose between covering the remaining uninsured or continuing basic public health functions, when they should be doing both.

The Legislature, a co-equal branch of government, needs to jump into the fray, sending the message that public health is important.

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