County of Marin Health and Human Services

HHS Clinic Integration: Frequently Asked Questions

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

What are we proposing?

The County dental and specialty clinics will close. HHS is recommending transferring patients to its trusted partner, MCC. MCC will open new clinics to care for current County clinic patients. No patients will lose access to quality care.

Where will the new clinics be located? 

At the same locations as the current County clinics. If the transfer is approved, HHS will lease to MCC both the 411 4th Street dental clinic and specialty clinic at 3260 Kerner Boulevard, both in San Rafael. Patients can take advantage of MCC’s extended weekend and evening hours.

Why are we proposing this change?

The primary reason is improving care in our community. MCC provides more comprehensive and integrated care than our 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.

How would this decision affect quality of care provided for Marin County residents?

The quality of care that local residents receive will be improved. 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 is not possible within the HHS’s clinic silos.

Emergency and urgent care services, including for dental care, will be expanded 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.

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

Patients will 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 subleasing and optimizing the available space at 3260 Kerner and 411 4th street, MCC will have 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.

As the community clinics have expanded, the role of HHS has appropriately decreased. For example, in these past two months alone, MCC conducted nearly 32,000 clinical visits; in contrast, HHS medical clinics are operating at 7% capacity. HHS now operates only 5 out of 31 safety-net dental chairs countywide.

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 will receive 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.

Will patients have higher copays and bills by receiving care through MCC?

No. Both MCC and HHS clinics operate under similar sliding scale fees for patients who do not have Medi-Cal or other coverage.

Services currently provided by the HHS clinics are not free and operate under a complicated fee structure, which does not provide patients as much flexibility as MCC offers.

Who makes the final decision? Will the public be involved in this process?

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 will inform patients at both clinics to make sure everyone is aware of the potential changes and to ensure continuity of care.

If approved, what is the proposed timeline for eliminating the HHS-operated 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.

What will this cost (or save) the county?

The County will save approximately $1 million per year if the proposal is approved.

Is this a result of our current Federal Administration?

No. Our clinic service numbers have continued to drop year after year, so exploring this option, with a partner that HHS has had a relationship with for decades, 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 will County clinic employees be affected by this decision?

33 full-time employees currently work in the County clinics.

The County will work to mitigate the transition’s effects on employees. Some employees will be reassigned to other programs within HHS. MCC will recruit HHS clinical staff for potential employment at MCC.

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