Stanislaus County officials concerned about Gov. Davis' proposed cuts to Med-Cal say they are encouraged that state lawmakers are resisting the plan.

Monday, the Assembly Budget Committee rejected the proposals, and last week the Senate Budget and Fiscal Review Committee decided to remove all cuts to the Medi-Cal program from the table.

"At least at first blush, these proposals are being rejected by the state Legislature," said Margaret Szczepaniak, managing director of the county Health Services Agency. "But the fight is far from over."

The governor has proposed a number of cuts to the state's health program for the poor, including:

• A 15 percent decrease in reimbursements to physicians who treat Medi-Cal patients.
• Lower income eligibility levels for the program.
• Cuts to benefits such as dental services, medical supplies, podiatry, hospice, vision care and physical therapy.

Nursing homes also would face a cut in reimbursements that could drive some out business, analysts said.

Davis also has proposed shifting responsibility for many programs to counties.

Stanislaus County, which operates public health clinics, would lose an estimated $1.5 million to $2 million a year if provider rates were cut. And it's unclear how the county would make up the losses.

Local officials also worry that people would have to verify their income and other information four times a year to stay on Medi-Cal.

State health officials estimate that the hassle of quarterly reporting alone would cause 193,000 people to lose eligibility. County officials predict chaos.

"What you would have is thousands of people without health insurance, looking for a physician who would take them without health insurance, or they would show up in emergency rooms for care," Szczepaniak said.

"There is also a chance that providers in the community are no longer going to be willing to accept Medi-Cal at a 15 percent decrease."

Kathy Harwell, a program manager for the Community Services Agency, said the agency would handle the quarterly reporting mostly through the mail. She said the agency would send the forms to clients; she's unsure how many would fill out the documents and mail them back.

The governor also has proposed pushing onto the counties the responsibility for long-term care for the elderly and disabled.

State money would be available to help the counties. But county officials said they know little about the needs of the elderly and the costs of caring for them.

"Our elderly population is growing," Harwell noted.

Some think the proposals would create such an upheaval that the Legislature will never approve them. But some local health officials are predicting months of uncertainty about what's going to happen.

"I am concerned that with the stalemate in Sacramento, they won't be doing anything, that we won't have a state budget in time," Szczepaniak said. "It's very difficult to plan in this atmosphere."

Bee staff writer Ken Carlson can be reached at 578-2321 or kcarlson@modbee.com.

Reprinted by permission of Modesto Bee.