The Medically Indigent Services Program (MISP), is a $20 million per year contract Fresno County has with Community Regional Medical Center to provide care for those who are medically indigent.
With the expansion of Medi-Cal, many who were previously uninsured now qualify for health care coverage. In response, the state has slashed $14 million from the County's budget to service the medically indigent. As a result, the County cannot continue to fund the MISP.
At Tuesday's meeting, advocates wore bandages over their mouths to symbolize the undocumented, who advocates said are voiceless in this matter.
"The County today is attempting to decimate our safety net under the guise that the Affordable Care Act is responsible for the lose of dollars," said Sandra Celedon, with the organization Fresno Building Healthy Communities.
Supervisor Henry Perea recognized the challenge this presents for the County's estimated 5,000 undocumented.
"From my perspective, even though there is some challenge within the indigent in getting signed up [for health care coverage], the bottom line is they can be signed up. It's just a matter of how effective the community and the county is in making sure that they do. But it's a different story for the undocumented," Perea said.
From the County's perspective, their hands are tied.
Perea said the program will probalby end within the next few months. But advocates hope the discussion won't come to an end.
"Attempting to eliminate the Medically Indigent Services Program is shameful. And attempting to do so without a public forum is deceitful," said Walter Ramirez with the Centro Binacional Para el Desarrollo Indigena Oaxaqueño (CBDIO).
Under federal law, emergeny rooms must see patients regardless of legal status. But advocates of the county program argue preventive and specialty care are the most cost-effective methods and the best for public health overall.
"Today the Board talked about the fact that people have access to emergency room care. Well we know that's the most expensive type of care and that's the type that we all end up paying as taxpayers, regardless of who accesses that care," Celedon.
She added that the County should instead focus on making preventive and specialty care accessible to people, regardless of legal status, so that the undocumented would not have to use emergency room care as a last resort.
In the meantime, Fresno County is in an ongoing lawsuit to repeal a 1984 injunction that orders the County to provide medical care for the medically indigent.
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