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Health Care Uncertain for Fresno County's Poor, Uninsured

Fresno County may end its contract with Community Regional Medical Center to provide care for the medically indigent because of changes in state funding as a result of the Affordable Care Act.

Changes in health care are having big implications for Fresno County's uninsured.

In the County, there are close to 200,000 people who are uninsured, according to Kevin Hamilton, deputy chief of programs with the Clinica Sierra Vista, a federally qualified health center.

Many who weren't previously eligible for Medi-Cal now are through Covered California.

"The folks we can't enroll are those undocumented adults and children who are being covered now by the MISP program," Hamilton said.

The MISP stands for the Medically Indigent Services Program-- a $20 million per year contract that Fresno County has with Community Regional Medical Center to serve the very  poor and uninsured population.

The Fresno County Department of Public Health normally receives $42 million dollars per year from the state, half of which is used to fund the MISP, according to David Pomaville, interim director for the Dept. of Public Health.

Now, that funding has been slashed to $28 million, Pomaville said the money won't be there to fund the MISP.

State funding has been reduced because Medi-Cal coverage has expanded.

"The county won't have the resources to continue the Community hospital contract," Pomaville said.    

This change could leave a portion of the population to seek health care through federally qualified clinics, like Clinica Sierra Vista. But care in clinics is limited, as they doesn't provide specialty care.

"So if that happens, the undocumented will no longer have an insurance program of any kind. So they'll have to get all of their care virtually through the ER, which is hideously expensive," Hamilton said.

Fresno County will continue its contract with CRMC for the first few months of next year, Pomaville said.

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