In The News

Providing health care with a net: Jennifer Hastings, Julie Hyer and Patrick Meehan

March 30, 2008

Imagine health insurance coverage as a tightrope. Some people -- those with comprehensive, affordable coverage -- walk along it easily, but others have a more precarious perch. Some may have had coverage at one time and slipped off because of a job or life change; others never had a chance to try this particular tightrope. Those of us who fall off the tightrope for any reason know that our health may depend on the strength and quality of the safety net that is supposed to catch us. We may not give the net much thought until we really need it, and by then it may be too late.

In Santa Cruz County, we are fortunate to have a very high-quality net. It's stretched and a bit frayed because so many people are falling off the health-insurance-coverage tightrope, but it's also fairly resilient. The "safety net" analogy is deliberate: here and elsewhere, the network of health care providers and clinics that provides care to the un- and underinsured is called the Safety Net system. Safety Net clinics include Cabrillo College's clinics, the Diabetes Health Center, Dientes Community Dental Care, Dominican Pediatric Clinic, Health Services Agency clinics, Homeless Persons Health Project, Planned Parenthood, Salud Para la Gente and Santa Cruz Women's Health Center.

Our clinics are represented on Santa Cruz County's Health Improvement Partnership [HIP] -- the local countywide collaborative of health, foundation, government and community leaders -- because they are an essential component of the county's overall health system. HIP focuses on creating a more integrated system of care among all our local providers, both public and private. Within that system, the Safety Net clinics play a vital role, working in tandem with other local providers and specialists who also treat Safety net patients.

The public and nonprofit Safety Net clinics operate on varying blends of state and federal grants, partial reimbursements for care provided under public insurance programs like Medicare and Medi-Cal, fees paid by patients [when they are able to do so], and support from the community in the form of donations, foundation grants and volunteers.

The funds are not plentiful, but the quality of care is extremely high, as is the volume of patients. Last year, our county's Safety Net clinics provided care to more than 40,000 individual patients, which translated to 172,913 patient visits. Our patients include the old and young, the working poor, Spanish and English speakers, south and north county residents, the homeless and people struggling with mental illness -- all of whom would have had great difficulty obtaining health care any other way. If they hadn't been treated by the Safety Net clinics, many of these patients would have flooded the county's emergency rooms and private physicians' offices, which already face their own financial pressures from reduced Medi-Cal and Medicare reimbursement rates.

The demand for Safety Net clinics' services is growing, fueled by more people unable to afford private health insurance and by patients recognizing that the quality of care they receive in these clinics is exceptional.

Our county's Safety Net providers receive high quality review marks because they are committed to providing holistic care -- care that responds to every aspect of a person's health -- and because they invest in case management. The result is a true "medical home" where a patient's history, current conditions and needed referrals are all know, understood and monitored in one central place.

Safety Net providers are dedicated professionals with impressive credentials who could have practiced in any setting, but choose day after day to provide care to those needing their help the most. Like many colleagues inside and outside the Safety Net system, we dream of a day when health care truly becomes a right and not a privilege. When that day comes, the safety net won't have to carry so much of the weight of the health care system because the entire system will be stronger, better and fairer than it is now. Meanwhile, the HIP will continue its efforts to improve both the Safety Net and the rest of the health care system to benefit all of us.

Jennifer Hastings is medical director of Westside Planned Parenthood. Julie Hyer is president of Salud Para la Gente. Patrick Meehan is executive director of Santa Cruz Women's Health Center.

Copyright ©2008
MediaNews Group