San Mateo County Officials Consider Funding for Indigent Care, Nursing

The grand jury reported that expenses for the medical center, which provides 95% of indigent care in the county, have been exceeding revenue by $150,000 per day. According to the report, 30% of patients at the medical center are indigent, 60% are Medi-Cal or Medicare beneficiaries, and 10% have private insurance or can pay for care.

The grand jury recommended a comprehensive study to determine the most cost-effective way for the county to provide health care to residents who cannot afford the cost of services. The county should consider managed care or contracting for sale or lease of the hospital to a third party, such as Stanford University Medical Center, the grand jury said.

In addition, the grand jury report recommended that the county define indigent care so that people who can afford to pay for health care services do not receive care at no cost. The report also recommended that the county develop a new way to evaluate patients' ability to pay and calculate the per-patient cost of indigent care.

San Mateo County will provide $54 million for medical center operation in fiscal year 2005-2006 (Ernde [1], Oakland Tribune, 7/1).

County Nursing Home

In related news, county officials said the county cannot afford to build a new nursing home to house patients at Burlingame Long-Term Care Center, which is administered by SMMC.

Two months ago, a county grand jury recommended a new facility for the nursing home's 250 residents, in part because of a lack of ground-level exits for use in an emergency. However, revenue would be insufficient to cover the cost of the new building, county officials said.

According to theTribune, county officials are "increasingly concerned" about the effect on the county budget of other rising health care costs at SMMC (Ernde [2], Oakland Tribune, 7/1).

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