CEO Editorial: Time to declare impasse on matching federal funds
For several months, Community Medical Centers and public officials have been working to salvage a process by which $54 million in matching federal funds could come to Community to help care for the needy. But we’ve reached an impasse, and I have contacted the county to say we have no choice but to abandon the effort and seek other supplemental-funding alternatives.
Providing health care for the Valley’s uninsured and underinsured is a huge challenge. Last year, as Community was renegotiating its Medi-Cal reimbursement, the federal matching-fund program was urged as a way to access additional money. It required Fresno County’s help. An amount equal to what the county annually pays Community for contracted indigent services -- $18 million – was sent by the county to the state to obtain a matching $18 million in new federal money. The entire amount was then sent to Community to help fill the gap between our costs and the usual government reimbursement. This federal match was to be obtained three years in a row.
But in January the federal Centers for Medicare and Medicaid Services (CMS) reviewed the transaction language and said it didn’t fully comply with regulatory requirements. Congressman Jim Costa convened conference calls with all levels of government to facilitate a solution. And CMS officials themselves offered a redrafting suggestion that would allow the federal matches to proceed. But Fresno County then had its own legal concerns with the CMS approach, and it became obvious at the County Supervisors meeting this week that those concerns would not be overcome.
An outside law firm instead recommended to the county an alternative funding source for obtaining the federal matching amount. But the alternative – reliant upon Community paying additional rent for the UMC facility – was clearly not viable for us and again probably not acceptable to the state and federal governments.
Therefore, we must recognize that we’re simply out of options and out of time. Accessing these new federal funds would have been very helpful to our mission and to our efforts to provide greater health-care access to our growing patient population. It is indeed a shame that we could not do what was necessary to access $54 million of new funding for a county with one of the nation’s highest concentrations of poverty.
But I sincerely thank the many people who, for some months, have worked hard trying to solve the puzzle.
Community Medical Centers is enjoying a very good year in many respects – including development of the Valley’s only academic regional medical center – and the loss of these special federal funds will not change that. It is time to focus our energy on other opportunities for resources to assist us as the Valley’s main safety-net provider and its most essential health care organization.