Community health centers face hard hits from budget cuts [Yakima Herald-Republic, Wash.]

Nov. 30--YAKIMA, Wash. -- About 100 people symbolically crowded into local hospital emergency rooms Tuesday, hoping to point out that cuts to community health clinics would unfairly send more Yakima Valley residents to ERs where care is more expensive.

The county's three community health centers -- the Yakima Valley Farm Workers Clinic, Yakima Neighborhood Health Services and Community Health of Central Washington -- rallied their staffs and patients to show what it would look like if people who depend on those centers had to instead go to one of Yakima's two hospital emergency rooms for care.

"Now more than ever, it's essential that people have access to the right care at the right time and the right place," Dr. Mike Maples, CEO of Community Health of Central Washington, told the crowd.

Executive Director Carlos Olivares of the Farm Workers Clinic said: "(These cuts) would hit this community disproportionately because we have more poor people," he said. "We have kind of reached our limit."

Legislators on Monday returned to Olympia for what Gov. Chris Gregoire has termed a "brutal" special session to slash $2 billion from the $32.2 billion 2011-2013 budget, on top of $5 billion in cuts handed down in May.

Last week, Gregoire released her budget proposals, which include elimination of the Basic Health Plan, the state subsidized health-care plan and Disability Lifeline, which provides medical assistance to disabled people with chronic conditions. Also slated for cuts are free or reduced-cost health-care programs for children like Apple Health for Kids, which was greatly expanded under Gregoire to cover families above the poverty level of $22,350 for a family of four.

Those programs are used by many low-income and seasonally employed people in the Yakima Valley who otherwise have little or no health insurance. Together, the three centers see 2,400 patients a day. Averaged out over 24 hours, that's the hundred extra people that showed up at the hospital ERs to make their point.

According to the conservative think tank Washington Policy Center, the governor's proposed cuts to community health centers total $25 million, less than 10 percent of their current state support. And despite the stunt's visual message, the center directors acknowledge that cuts would not mean that clinics will close their doors to low-income clients.

"Those patients are still our patients, and if they come for care, we'll provide care, and they all essentially qualify to receive discounted fees at our clinics," Maples said.

But, he added, "Even if you have as low as a $20 charge for a visit, as opposed to full coverage, if you don't have $20, it's going to definitely make an impact on your choice of seeking care or going without."

Gregoire has proposed buying back several program cuts -- including the Basic Health Plan and several cuts to education -- with a half-cent sales tax increase, projected to raise nearly $500 million by June 2013.

Anita Monoian, CEO of Yakima Neighborhood Health Services, said the programs on the line are worth saving.

"This is not a time to weaken our safety net," she told the crowd. "I'll pay half a penny" to keep those programs alive, she said.

While calling for more state spending to support their clinics, administrators say they've done their part to hold the line on their own pay increases in recent years.

Administrative salaries have been frozen for five years at the Farm Workers Clinic, Olivares said. Monoian said she voluntarily froze her own salary four years ago and that other Neighborhood Health administrators' pay was frozen last year. Maples said the only raises at Community Health in the past few years have been cost-of-living increases.

Monoian's total annual compensation -- pay and benefits -- is $356,889; Maples earns total compensation of $252,980, and the comparable figure for Olivares is $625,008, according to tax forms filed by the nonprofit health centers for the 2009-2010 fiscal year. Board chairmen for the organizations have said they pay their top administrators market rates.

For some "critical" employees, such as top information technology managers and doctors, Olivares said pay increases are necessary to retain the best workers. Maples and Monoian agreed, saying even in the sluggish economy, there's a competitive market for those positions.

--Molly Rosbach can be reached at mrosbach@yakimaherald.com.

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