County medical center eyed for closure 

With the publicly funded San Mateo Medical Center draining tens of millions of dollars from county coffers each year, the Controller’s Office has recommended shutting the facility to save cash.

At least $24 million a year could be saved by outsourcing indigent patient care to other area hospitals, according to a recently released Controller’s audit.

The medical center is estimated to spend nearly $70 million this year caring for about 16,200 indigent and extremely low-income patients, according to Controller Tom Huening. Along with underfunded retirement and medical benefits, thehospital is one of the greatest stresses on the county’s general fund, Supervisor Jerry Hill said.

California law puts the burden of caring for the indigent onto the county, which estimates the cost at $30 million to $35 million. But while some counties assign indigents in need of medical care to various privately run hospitals and then pay the medical bill, San Mateo County bears the cost of staffing and equipping a hospital in an environment of decreasing Medi-Cal reimbursements for impoverished and low-income patients, officials said.

The idea of outsourcing patients has been floated in years past, but the current fiscal climate makes it a more pressing issue today, Hill said.

"We are making the case that the patients will be provided with the appropriate care and there will a savings [to the county] of about $24 million," Deputy Controller Kanchan Charan said.

But some say the planned change won’t go as smoothly as officials hope.

"They’re idealizing it," said San Carlos resident Heather Qwilleran, who is uninsured and a medical center patient.

Qwilleran, who relocated to San Mateo County after the public hospital in San Jose was shut down, said people she knew at the time had to take several buses or taxis to receive treatment from hospitals across town.

Melissa Rodgers, director of the Health Consumer Center at the Legal Aid of San Mateo County, opposes shutting the medical center. "Having people spread out all over the county would decrease accountability," Rodgers said.

Shutting the medical center would strain other hospitals’ ability to handle patients, which is why the county has begun a pilot program to screen out some of the estimated 2,700 patients the county isn’t legally required to serve, Hill said.

In addition, the county’s Blue Ribbon Task Force on Adult Health Care Coverage Expansion hopes to have a plan for how it can insure or otherwise pay for indigent patient care by June, said Hill, a task force member. Hill said he doesn’t expect a final decision on the hospital until this summer.

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