County of Marin Health and Human Services

HHS Clinic Integration: Frequently Asked Questions

Integration of Department of Health and Human Services (HHS) Dental and Specialty Clinics with Marin Community Clinics (MCC)


What is happening with clinic integration?

The County dental and specialty clinics are closing and transferring patients to its trusted partner, MCC. MCC is opening new clinics to care for current County clinic patients. Patients  are not losing access to quality care.
The HHS dental, immunization and STD clinics closed on Thursday, November 9, 2017. The HIV, TB, and Hepatitis C (Specialty) Clinics will close on Wednesday, January 24, 2018.

Where are the new clinics located? 

MCC is operating the new clinics at the same locations - 411 4th Street and 3260 Kerner Boulevard.

Why did HHS decide to close its clinics?

The primary reason was to improve care in our community. MCC provides more comprehensive and integrated care than County clinics.
Patients who have comprehensive and integrated care have improved outcomes, including fewer emergency room visits and hospital readmissions.
Integrated dental care is essential to improving health. Combining medical and dental services increases opportunities to address health issues related to both oral health and related conditions, such as obesity, heart disease, and tobacco addiction.

In addition, MCC receives three times the reimbursement rate that the County receives. In fact, County-run clinics require a subsidy of over $100 per visit from local taxpayers, costing the County nearly $1 million annually.

Does integration affect the quality of health care that County residents receive?

The quality of care that local residents receive will improve. MCC meets the most rigorous federal criteria for accreditation.
Through MCC’s integrated health system, 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, Hepatitis C, and diabetes, is available. Such integration was not possible within the HHS’s clinic silos.

Emergency and urgent care services, including for dental care, are expanding for current County patients.
MCC has a longstanding Dental Advisory Committee to ensure the highest quality of dental care for its patients. This committee already includes County staff as well as patient representatives and clinicians to ensure the highest quality of care.

Do patients have the same level of access to clinic services at MCC? Does MCC have the capacity to take on more patients?

Patients have greater access to care. MCC offers evening and weekend hours, has a greater capacity for emergency dental care, and offers an online patient portal for convenient scheduling and other needs.
MCC already offers services in both locations. Through optimizing the available space at 3260 Kerner and 411 4th Street, MCC has the capacity to take on over 14,000 additional medical visits per year to allow more residents immediate access to care with the use of eight medical exam rooms.

County-run clinics require a local subsidy for visits costing nearly $1 million in local tax dollars annually. In contrast, as a Federally Qualified Healthcare Center, MCC receives full reimbursement to see these patients and provide the care they need.
MCC offers the same services that the HHS clinics currently provide. Any unanticipated gaps in services will be addressed.

Do patients have higher co-pays and bills at MCC?

No. MCC provides more flexibility in payment than HHS clinics. MCC operates under sliding scale fees for patients who do not have Medi-Cal or other coverage.

Who made the final decision to integrate the clinics?

The final decision was made by the Board of Supervisors on September 12th, 2017 after a public hearing.
For more information on the decision, see the September 13th, 2017 press release.

Have patients been informed of this potential change?

HHS has been informing patients at both clinics to make sure everyone is aware of the potential changes and to ensure continuity of care.

What does this cost (or save) the county?

The County will save approximately $1 million per year.

Is this a result of the current Federal Administration?

No. Marin HHS specialty clinic service numbers have continued to drop year after year.  Exploring this option with a trusted partner became an obvious solution, regardless of current activity at the state or federal levels. The County will continue to monitor changes at the federal and state level and respond accordingly.

How are County clinic employees affected by this decision?

33 full-time employees were working in the County clinics at the time of the decision.
HHS has worked with employees and Human Resources to identify opportunities for those interested in continued county employment. Some employees have been reassigned to other programs within HHS. MCC has also recruited HHS clinical staff for employment at MCC.

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