Lost among the good news of an on-time state budget last month was a policy decision that will tear a gaping hole in California’s safety net. The $224 billion spending plan did not address the frail and vulnerable patients at hospital-based skilled-nursing facilities, leaving them and their families adrift without access to the vital health care they need.
California’s skilled-nursing facilities are in crisis. In the last five years, approximately 40 hospital-based skilled-nursing facilities in California (about one-third) have closed due to financial pressures and many more find themselves at the brink of bankruptcy and closure. This is the result of draconian Medi-Cal cuts that were implemented to deal with the budget crisis two years ago. Although California’s budget boasts a surplus this year, we are without a commitment to reverse those cuts and protect our society’s most vulnerable patients.
Health care providers are already making plans, as distressful as they are, to eliminate services and even close some facilities altogether. In fact, one such facility in San Diego County has already announced that it will close soon, and there will likely be more. It’s a brewing crisis that cuts across partisan and geographic boundaries.
To illustrate, on the surface, Plumas County and San Francisco may not appear to share much in common. One is steeped in a rich gold history, a tranquil and rural community occupying 2,613 square miles and home to just over 20,000 residents, many of whom who have lived there for generations. The other is a thriving urban city, squeezed into less than 47 square miles and with a population 55 times larger than Plumas. Yet both are experiencing a Medi-Cal funding crisis that threatens our safety net and our quality of life. We share a cause to ensure that our residents will have access to the skilled health care they need. That’s why we united with hospitals, doctors, labor and business groups throughout California to urge support for AB 900, which would reverse the devastating Medi-Cal costs.
We need not look far for local impacts. Without AB 900, San Francisco’s Jewish Home and Laguna Honda will face retroactive cuts of $19 million and $57 million, respectively. In fact, Jewish Home has already issued layoff notices and is contemplating a financial reorganization. In Plumas County, the retroactive cuts alone total $2.6 million and could cause the closure of Eastern Plumas Health Care, the only skilled- nursing facility in a vast rural region. The chief executive there has said that forced closure would be a “heartless act.”
If our facilities close or reduce services, where will our patients go and who will give them the specialized care they need and deserve? Many would have to transfer to facilities hundreds of miles away from their homes and families. This is shortsighted and irresponsible. And it makes no sense, given that reversing the cuts would actually save the state money in the long run.
According to a recent economic impact analysis conducted by the California Hospital Association, the consequences of hospital-based skilled-nursing facility Medi-Cal cuts will be the loss of 36,000 jobs throughout the state and $2 billion in lost economic activity. Losing skilled-nursing facilities would mean putting patients in more expensive acute care. Imagine asking a health care professional to place all their focus on patient care knowing their livelihood could be ripped away at any moment.
If the Legislature and Governor Brown fail to address this critical issue when they return next month, it will tear a significant hole into our already fragile health care safety net. These cuts don’t simply happen in a vacuum, they create ripple effects throughout our communities and the state.
California citizens, whether from rural Plumas County or the busy environs of San Francisco, deserve a common-sense and humane solution. The Legislature and the Governor must act now to reverse the Medi-Cal cuts and ensure that those who have been productive all their lives, and who need our help now, are not the victims of ill-considered cuts.
Ed’s Note: David Chiu is the chairman of the San Francisco County Board of Supervisors. Jon Kennedy is a supervisor in Plumas County.