This is an open letter to our state legislators:

I am writing to advise you of the devastating impact the governor’s proposed health care budget cuts would have on the financial stability of Community Health Clinic Ole and our ability to continue to serve our 18,000 patients with 60,000 visits annually. Clinic Ole, a Federally Qualified Health Center, is the only source of affordable health care for low-income, uninsured residents in Napa County, as well as for one-third of the county’s MediCal-managed care beneficiaries.

If all the governor’s cuts listed below are approved, many community clinics will have to radically downsize; some will be forced to close their doors. For Clinic Ole it could potentially result in up to 50 percent of eligible Napa County MediCal enrollees losing coverage, which would translate into a $1.8 million loss annually for our clinic:

• a reduction of income eligibility levels for MediCal from 100 percent of the poverty level ($21,200 a year for a family of four) to 61 percent of the poverty level ($12,900 a year for a family of four)

• a wait of five years to apply for benefits for legal immigrants

• elimination of optional benefits such as adult dental, podiatry, ophthalmology, vision screening and glasses, specific durable goods, and all mental health services except psychiatry

• quarterly re-application for both adults and children

• reduction in funding to counties that would seriously impact their ability to hire additional eligibility workers to process quarterly applications in a timely manner

• payment delays to providers of one month twice a year

In addition, the expected delay in approving the state budget will result in delayed MediCal and other payments from state grants and programs to Clinic Ole until the budget is signed, which may not be until the fall. In the meantime we will continue to serve patients who are currently on MediCal, even though any cuts in the final budget will be retroactive to July 1 and we will not be paid for services rendered that end up being cut.

Community clinics and Federally Qualified Health Centers like Clinic Ole are considered the “safety net” for health care in this country. We exist to “catch” and provide medical care to individuals who have no other access to health care. We are mandated to accept MediCal and Medicare patients and to have sliding fee scales that deeply discount fees. Because these fees are so low, clinics rely heavily on MediCal income to support services to the uninsured. In fact, Federally Qualified Health Centers receive an enhanced MediCal reimbursement with the expressed goal that the enhancement will, to some degree, offset the deficit inherent in serving the uninsured.

The effect of the governor’s proposed cuts will be far-reaching and could end up costing the state and taxpayers just as much, or more, than any potential savings from cutting services. Patients who can’t get into clinics for care will utilize hospital emergency rooms and many will be unable to pay the charges; our local hospital retrieved just 26 cents of every dollar it billed patients last year.

While we understand the severe economic crisis in California, we also know that the safety net will not be able to compensate for the number of MediCal patients who will join the ranks of the uninsured. As legislators you will be looking at the potential collapse of the last system of care available to thousands of low-income, uninsured Californians.

Clinic Ole’s physicians, patients, staff and board members urge you to look at the real and serious consequences of the health care cuts proposed in the state budget. The end result will be the demise of the safety net and the end of affordable health care for the poor and uninsured with higher costs for all.

(Long is the board chair of Community Health Clinic Ole. Shafer is board member emeritus of Community Health Clinic Ole.)