Supervisors Vote to Improve Health Services for Public While Cutting Costs:
The Marin County Department of Health and Human Services (HHS) will close its dental and specialty health clinics this fall and transfer care of patients to Marin Community Clinics (MCC) without missing a day of service to the community. MCC, a federally qualified health center, will provide equivalent services at the same locations as the County-operated clinics that will close.
The Marin County Board of Supervisors voted unanimously September 12 to no longer provide services through its dental and infectious disease specialty clinics. The target date to close the County clinics is November 3, but the clinics in San Rafael will not close until transition criteria have been met. MCC plans to open its clinics upon the closure of the County clinics.
Dr. Lisa Santora, HHS Deputy Public Health Officer, said the County’s federally qualified health centers provide comprehensive primary and specialty care, dental care, behavioral health care, as well as the support services necessary to meet the needs of Marin’s most vulnerable residents.
“Today, we have an unprecedented opportunity to build an integrated, sustainable system of care in Marin County that ensures quality, increases access, and improves health outcomes,” Dr. Lisa Santora.
MCC is the largest safety net health provider in the county and sees more than 80 percent of Marin’s MediCal patients. At the MCC offices, a patient can receive preventive care and treatment by a dedicated primary care physician while having access to specialty and dental services as needed. That is not possible with the specialized County health clinics.
Patients can work with their primary care provider to manage their chronic disease, address acute health care issues, access care for mental health and substance use, and receive preventive services. Specialty care, including care for HIV and Hepatitis C, also is available.
Studies show that patients treated with coordinated care have improved medical outcomes, including fewer emergency room visits and hospital admissions. MCC has received national recognition for primary care quality benchmarks, including access to same-day appointments.
“We’ve had a long and effective partnership with the County meeting the health care needs of low-income residents,” said Dr. Mitesh Popat, Chief Medical Officer for MCC. “We’re committed to the same high standard of care these clients received in HHS clinics. We can add value by offering it in an integrated primary care setting.”
While public use of the County’s specialty clinics has declined in recent years, MCC has served more than 175,000 visitors annually at its nine clinics across Marin.
Santora reported that the Board decision will result in a reduction in the County workforce. Fourteen employees will be reassigned to other positions to meet program needs in other HHS units. The County is in negotiations with the union to agree on separation and severance agreements for approximately 19 employees.
“Our overarching mission of this change is to improve care and services for the public,” said Dr. Grant Colfax, Director of Marin HHS. “We will work hard to mitigate staffing changes as much as possible, inform clients and other stakeholders of the commitment to a smooth transition of care, and continue to build the trusted partnership between HHS and MCC.”
Financial factors were weighed in the Board’s decision as well. Federally-qualified health centers such as MCC receive substantially higher reimbursement rates than the County's clinics. For every patient visit, MCC receives about three times the reimbursement rate that the County receives. In fact, County-run clinics require a subsidy of more than $100 per visit. The County is facing a $7.4 million budget deficit over the next two years, and the transfer of the clinic clientele would result in an ongoing administrative savings of about $2 million annually.
“There aren’t many opportunities for us to maintain services in the community and save taxpayers money, but this is one of them,” County Administrator Mathew Hymel said.