Adithya Sambamurthy/The Bay Citizen

Patients in a crowded waiting room await care at the Gardner Family Health Network clinic In San Jose on Tuesday, June 28, 2011

On a recent Friday morning, more than a dozen patients crowded into a waiting room at CompreCare Health Center in San Jose. Many were Hispanic mothers with young children, there to see an obstetrician, pediatrician or family practitioner.

That already busy waiting room is about to get busier. Health care reform is projected to bring insurance to as many as 50,000 Santa Clara County residents by 2014. Some of the burden of tending to the anticipated influx of new patients will fall to health centers like CompreCare, which cater to low-income patients.

But the budget deal struck in Sacramento last week highlights a growing paradox for providers on the front lines of health reform. The budget, which strips $1.5 billion from Medi-Cal, exacerbates a financial crisis for organizations bracing for such an influx.

“How can you serve more people when you have to cut back?” said Reymundo Espinoza, chief executive of Gardner Family Health Network, the nonprofit organization that operates CompreCare and four other similar health centers in Santa Clara County.

Espinoza, who has headed Gardner for 25 years, said the network was considering reducing the number of doctors and clinicians for the first time in two decades because of the state budget crisis and severe cuts to federal financing.

Gardner has failed to break even in each of the last two fiscal years after losing $2 million in revenue from the state. The network was already projecting a $1 million shortfall this year before passage of the state budget, which will squeeze Gardner’s bottom line further.

As a result, plans to extend hours and services at existing clinics in the county, as well as plans to open a new one, are in jeopardy, according to health care administrators and county officials.

“You can’t suddenly give health care coverage and not have the delivery system available to receive them,” said Elizabeth Darrow, chief executive of Santa Clara Family Health Plan, the county’s public health plan, which provides coverage to 130,000 low-income residents. “It’s illogical.”

The strain on health centers like CompreCare, which are central to health care reform, could make or break the new law, Darrow said.

“There is pent-up demand, and we have to be ready for it,” she said. “There is potential for health care reform failing because of it.”

Gardner Family Health Network currently serves 37,000 patients in Santa Clara County; 90 percent are regarded as low income. Gardner’s $52 million budget is financed through a combination of public insurance programs like Medi-Cal, California’s Medicaid program, and grants from state, federal and local agencies.

Forty-five percent of Gardner’s patients are covered by Medi-Cal; nearly the same percentage has no insurance at all. Yet the clinics turn no one away.

“If you are sick, you will be seen,” Espinoza said.

• 
• 
• 
• 
• 
• 
•