Health care expansion for low-income residents in works

Before federal health care reform begins taking effect in 2014, both Yuba and Sutter counties will be part of a $10 billion expansion of health care coverage aimed at low-income residents.

The expansion plan, under the consortium group County Medical Services Program, will build on existing services for more than 54,000 residents across more than 30 rural California counties.

Lee Kemper, executive director for the Sacramento-based program, said counties are creating the services and how to deliver them now, before formally rolling out the expansion on Jan. 1, 2012.

"Adding to the rolls will allow us to receive more federal funding," Kemper said. "That in turn makes it possible for more people to get services."

The County Medical Services Program now works alongside other health care programs for low-income residents such as Medi-Cal and Healthy Families, state versions of federal programs.

CSMP services are available to people who make two-thirds of the federal poverty level, which is $900 a month for a single person. Users must also pass assets guidelines and pay per-appointment fees.

Under the expanded program, eligibility will change to income the same as the federal poverty level, with the assets guidelines requirement and appointment fees eliminated, he said. They'll still have to prove citizenship and identity.

Those enrolled in the program receive basic health care needs such as physician visits, lab and radiology exams and dental services, but not such services as alcohol and drug treatment or pregnancy-related care.

Kemper said his program contracts on behalf of counties, clinics, doctors and other medical providers to work with two insurance groups for payment.

The initial $10 million for the expansion, formally known as the Low Income Health Program, came through state officials lobbying the federal government.

In Yuba County, the changing eligibility will add about 600 people to the program, for a total of 2,381. Sutter County officials said they didn't have an estimate on how many would be added.

The program's expansion is designed not to increase health costs for the counties.

Yuba County Supervisor John Nicoletti, who is on the CSMP's governing board, said the county currently pays $100,000 annually to be part of the consortium, but gets $6.5 million for care in matching federal money.

After 2014, though, he's concerned the formula will change as more indigents move into federal health care programs.

"The systems they'll be using are depending on existing systems, but they're taking away local control," he said.

Nicoletti said he joined the CSMP board partially to keep control as local as possible.

Directors at clinics providing services to the indigent, such as Ampla Health, formerly Del Norte Clinic, in Yuba City, expect to become more involved as expansion moves forward.

Hilton Perez, director of planning and development for Ampla, said his not-for-profit group is already bidding to provide behavioral health services under the program next year, and already participates in other health programs for lower-income residents in Yuba, Sutter, Butte and other counties.

"We're in the forefront of providing services to those who can't get services because they can't be insured or have other issues," Perez said. "It's a humongous enterprise to cover every single person who's uninsured."

CONTACT reporter Ben van der Meer at 749-4786.