On any given day, nearly half the people in Sacramento’s emergency rooms have no urgent care needs and should be seeing a regular doctor instead.
But a constellation of factors – a shortage of primary care doctors, physicians shunning Medi-Cal reimbursement, a lack of access to clinics, a lack of health insurance – has pushed more and more people into hospital emergency departments.
On Thursday, the Sierra Health Foundation took steps to give patients more options and help remedy the problem of emergency room overcrowding. The foundation announced it will give $1.5 million to five regional community clinic networks to expand their capacity to see more patients.
Another $1.5 million will go toward supporting public education, community engagement and a continuing public policy partnership involving the four major hospital systems in Sacramento – Dignity Health, Sutter Health, Kaiser Permanente and UC Davis Medical Center.
The move is coming just in time. By January, an estimated 227,000 newly eligible Medi-Cal enrollees will be looking for places to get health care as the Affordable Care Act goes into effect. Expanding the community clinics will go a long way toward making sure the region’s safety net is not overwhelmed, foundation officials said.
Chet Hewitt, CEO of the foundation, said his organization is using the funds to make a significant investment in building health care capacity at the clinics. “It’s big for us,” Hewitt said. “We in the Sacramento region are partnering to do all we can so that every one who needs primary care gets it instead of going to the emergency room.”
Researchers from the University of California, San Francisco, reported in the Journal of the American Medical Association that California emergency room visits by adults age 19 to 64 rose by 13 percent between 2005 and 2010.
The majority of those patients were covered by Medi-Cal, California’s version of Medicaid, which many private physicians do not accept because reimbursements have traditionally been low. Others flocking to the the emergency departments lacked health insurance.
But because the community clinics, which must follow federal guidelines for quality care, accept Medi-Cal patients and even welcome the uninsured, officials expect the overflow from emergency rooms to shift over to the clinics.
In Auburn, for example, the Chapa De Indian Health Program’s clinic is undergoing an expansion, CEO Lisa Davies said. The program sees 10,000 patients in Placer County and 7,000 in Nevada County. The funding boost will allow the program to hire five new health care providers and accept 6,000 to 7,000 additional patients, Davies said.
In Sacramento, clinics operated by Wellspace Health will continue expanding. As recently as 2008, Wellspace Health – formerly called The Effort – had only five exam rooms. With the help of federal stimulus funds, the network grew to 60 exam rooms and, with the assistance of foundation funding, expects to grow to 100 exam rooms in numerous locations throughout the county, said Jonathan Porteus, CEO of Wellspace Health.
A two-clinic network called Elica Health Centers specializes in serving ethnic immigrant populations in midtown and West Sacramento. “New immigrants arriving in Sacramento come to America with a dream for better lives,” said Elizabeth Cassin, CEO of the health centers. “But when they get here, a harsh reality greets them. There’s no work. Food and housing are in short supply. Eventually an unhealthy sedentary lifestyle sinks in, eroding their well-being. We provide healthy living learning and prevention.”
Cassin said Sacramento’s poverty level is 54 percent above where it was in 2000. “That is our population,” she said. “We rely on local health care providers to donate their time and efforts.”
Also receiving the foundation’s funding is Cares Community Health, an expansion of a longtime clinic in downtown Sacramento that formerly focused mainly on helping a population stricken with AIDS. The new community clinic is taking over a neighboring building to provide full-service health care to patients.
Lastly, Winters Healthcare in Yolo County received foundation funding. In 2012, the clinic provided nearly $400,000 in charity care to those lacking health insurance, many of them farmworkers based in the nearby agricultural belt. To reach out to that population, the clinic uses promotores, or health educators, to visit seasonal migrant camps, said Chris Kelsch, head of Winters Healthcare.