Saint Agnes Medical Center is paying $2.1 million to nonprofit organizations to comply with an order by the California attorney general that the hospital maintain its charity care to the community.
The hospital has awarded $1.6 million to Saint Agnes Home Health and Hospice and $125,000 each to Clinica Sierra Vista, WestCare California, Fresno State Foundation and Camarena Health. The distribution has raised eyebrows among some community activists.
The nonprofit Catholic-based hospital in northeast Fresno had asked the attorney general to lower an annual charity-care minimum, established by the state three years ago, from $7 million to less than $5 million. The money covers patients who had no insurance or means to pay for their care in 2015.
Saint Agnes argued the minimum should be reduced because fewer people are without insurance since the implementation of the Affordable Care Act, also known as Obamacare.
The attorney general refused the hospital request in September and ordered Saint Agnes to pay $2.1 million to organizations that provide direct care. On Nov. 18, Saint Agnes notified the attorney general’s office of its distribution of grant funds.
“The organizations represent the best opportunity to help meet the biggest health needs across the four-county region, including overall access to medical and behavioral health services, and treatment of chronic conditions such as asthma, diabetes and obesity,” Bret Gallaway, a hospital spokesman, said in an email.
Saint Agnes’ request to reduce its charity care came under attack from community members earlier this year, and on Monday the hospital’s decision to give $1.6 million to Saint Agnes Home Health and Hospice was questioned.
“You have $500,000 that goes to four health-based organizations and the remaining $1.6 million stays within Saint Agnes Medical Center’s systems. It’s like taking money from one pocket and putting it into another,” said Noe Paramo, co-director of Sustainable Rural Communities Program at the California Rural Legal Assistance Foundation.
But Paramo said he understands the need for hospice care, especially for Latino seniors.
Gallaway said Saint Agnes Home Health and Hospice operates independently of Saint Agnes Medical Center. The organization expects a nearly 11 percent increase in the need for home health by 2020, he said.
The home care and hospice nonprofit has seen an influx of patients who are needy, administrator Cynthia Gutierrez said. “The last couple of months, over 30 percent of our business is to the poor and uninsured.”
The four other agencies have plans for their grants:
▪ Clinica Sierra Vista, which operates health centers in Fresno and Bakersfield, will use the funds to increase access to primary-care services in Fresno, CEO Stephen Schilling said.
▪ Camarena Health, which operates clinics in Madera, will use the money toward developing a school-based health center at Madera South High School, CEO Paulo Soares said.
▪ WestCare California provides substance abuse and mental health services in Fresno and will use the money to provide additional mental health support to clients, said Shawn Jenkins, senior vice president.
▪ The grant will allow the California State University, Fresno Foundation to expand mobile-health unit services, said Shirley Melikian Armbruster, associate vice president for university communications. Students majoring in nursing, athletic training and dietetics travel to communities to provide free health services and education for those who lack access to health care.
Paramo said the agencies provide necessary direct care, and the groups deserve more investments.
In the future, however, Paramo said he hopes that charity-care funds are invested in building sustainable healthy communities by addressing poverty, nutrition, habitable housing, violence and mental health.
And, he said: “We will continue to hold hospitals like Saint Agnes accountable … for how they use their charity-care dollars.”
However, there is no requirement for nonprofit hospitals, which receive tax exemptions in exchange for providing charity care, to get state approval to modify their charity-care minimums.
Saint Agnes was an exception – it needed state approval because governance of the hospital changed three years ago when Trinity Health Corp. and Catholic Health East merged. The attorney general set Saint Agnes’ charity care minimum at $7 million at that time.