Title
a. Accept an oral presentation from California State University Monterey Bay faculty summarizing an analysis of access to care through safety net providers in Monterey County commissioned by the Monterey County Health Department and as requested by the Board of Supervisors; and
b. Adopt the findings as the basis for safety net expansion in Monterey County; and
c. Direct staff to initiate a complimentary study assessing the safety net from the user's perspective.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Accept an oral presentation from California State University Monterey Bay faculty summarizing an analysis of access to care through safety net providers in Monterey County commissioned by the Monterey County Health Department and as requested by the Board of Supervisors; and
b. Adopt the findings as the basis for safety net expansion in Monterey County; and
c. Direct staff to initiate a complimentary study assessing the safety net from the user's perspective.
SUMMARY/DISCUSSION:
In Monterey County in 2009, 42% of residents were low income and uninsured or enrolled in public health care safety net programs. Implementation of the 2010 Affordable Care Act (ACA) in Monterey County over the next several years will provide opportunities for safety net expansion and collaboration to address projected capacity demand. A survey of Monterey County's safety net system was commissioned in 2012 by the Monterey County Health Department to collect the baseline system data needed for efficient planning and to provide guidelines for expansion.
California State University Monterey Bay faculty will present a summary of their analysis of the current safety net system of providers who serve residents of Monterey County and capacity projections to assist with planning to meet expected increases in demand beginning in 2014. The report provides estimates for future capacity needs based on the current levels of insured and uninsured and projected rates of enrollment of those newly eligible. Not all newly insured will be new to the safety net system as currently they self-pay for services. Using the most likely scenario (gradual enrollment and use and 75% new to the system), the report indicates a projected deficit after 2014 for primary care access in North County and Salinas. As these preliminary findings were released, Monterey County Health Department staff met with current providers in these areas to determine potential growth. Clinica de Salud del Valle de Salinas (CSVS) has committed to add one (1) FTE provider in their Pajaro clinic and (1) FTE provider in their Castroville clinic. CSVS has also submitted a New Access Point grant for North Salinas which would accommodate two (2) FTE providers. In addition, the presentation will cover issues of importance to community members who submitted comments on the initial findings at public meetings held across the County. These latter findings indicate further assessment from the community's perspective will be an important addition to guide planning efforts by the County's safety net providers.
Limitations of the report include the inability to completely quantify the newly created interest by private providers and clinics in Medi-Cal as an accepted payer source due to insurance expansions under ACA. Additional access points through private providers and clinics would reduce projected safety net capacity needs.
OTHER AGENCY INVOLVEMENT:
Natividad Medical Center provided partial funding for the completion of the study.
FINANCING:
There is no fiscal impact to the county general fund with receiving the 2013 Safety Net report.
Prepared by: Krista Hanni, Planning, Evaluation, and Policy Manager, 4586
Approved by: Ray Bullick, Director of Health, 4526
Attachments:
A. Phase I Report: Preliminary Profile of Health Care Needs and Safety Net Providers that Serve Residents of Monterey County on file with the Clerk of the Board
B. Phase I Report Appendices on file with the Clerk of the Board
C. Phase III Report: Health Care Reform: An Analysis of Demand for Health Care Services & Safety Net Provider Capacity to Serve Monterey County Residents on file with the Clerk of the Board
Note: Phase II was the development of the surveys used to collect data for the Phase III report. Appendices to the Phase III report are the four provider surveys. They are available on the Monterey County Health Departments website at www.mtyhd.org