Indigent healthcare threatened

County budget fallout reaches Care Clinic

An indigent care clinic at The Memorial Hospital will remain open for at least three more months despite county budget cuts that wiped out one of the clinic's major funding sources.

Last-minute county budget cuts stripped an additional $50,000 from the hospital's already diminished county funding. The cuts threatened to close the Moffat County Care Clinic, which treats indigent clients on a sliding scale.

Since 1994, Moffat County has helped TMH offer the service by providing annual funding of $39,600. Beginning in 2004, the county's funding of the clinic will drop to zero.

Each year, TMH subsidizes more than half of the clinic's operating costs, chipping in more than $50,000 annually, according to Hospital Administrator Randy Phelps.

The hospital already had adopted the 2004 budget when the Moffat County Board of Commissioners announced the additional cuts.

At a meeting Tuesday of TMH's Board of Trustees, Moffat County Commissioner Marianna Raftopoulos apologized for the last-minute announcement, explaining that the county was waiting to see if a debt-restructuring scheme would eliminate the need for the cuts. When the restructuring fell through, the county announced it would cut TMH's budget an additional $50,000 and eliminate one line item earmarked for the indigent care clinic at TMH.

The hospital reviewed its budget and decided to keep the clinic open at least until March, when a grant application may come through to save the clinic for two more years.

TMH is waiting to hear whether it will receive a two-year, $100,000 grant from the Caring For Colorado Foundation. The hospital may receive notification as early as February, according to Pam Thompson, TMH's community relations director.

If Caring For Colorado denies the grant application, TMH will face a tough decision with regard to the clinic's future. Historically, the hospital has been able to offset the difference between the county funding and the cost of operating the clinic. But the hospital lost money in 2003, and is predicting a net income of only $85,000 in 2004.

In the face of poorer financial performance, TMH is less able to absorb the cost of operating the indigent clinic.

But even if the clinic loses money, it's cheaper than the alternative, according to TMH's chief financial officer, Roger White.

If the clinic were to close, its patients still would require medical treatment. Without insurance or cash to pay for healthcare, those patients simply will end up in TMH's emergency room. And treating the patients in the emergency room is much more costly than treating them in the care clinic, White said.

One way or another, TMH will end up treating the indigent clients.

The clinic "provides care in an earlier stage, before (the condition) develops into an emergent, urgent situation," White said. "It's still a less expensive venue for us than the ER."

White explained that treating the patients in the clinic is much cheaper in the long run than treating them, almost inevitably, in the hospital's emergency room.

The clinic was established to treat Medicaid patients who could not be seen anywhere but the emergency room because local clinics did not treat Medicaid clients, White said. The emergency room is a costly and inefficient way to treat people for routine healthcare that could be taken care of in a doctor's office.

"The whole experience is more expensive when it goes through the ER," said Jack Bonaker, the secretary/treasure of the TMH Board of Trustees. "To my way of thinking, the Care Clinic is absolutely critical to the community and the hospital. I don't see how we can close it under any circumstances."

Jeremy Browning can be reached at 824-7031 or jbrowning@craigdailypress.com

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