Bill would scrap Suffolk clinic fee rule

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Visits to Suffolk's public health clinics declined by 31 percent between 2010 and 2012, records show, and one lawmaker is blaming county fees for the decrease.

Legis. Robert Calarco (D-Patchogue) has introduced a bill to scrap the 2011 requirement that all uninsured patients show a Medicaid denial letter or automatically pay the highest single visit fee: $75.

Previously, the county asked uninsured patients only to verify their income against the federal poverty level, charging between $35 and $75 based on family size. Calarco would like to return to that policy, saying too many residents can't procure the documents needed to obtain a formal Medicaid denial.

"It's counterproductive to the health center mission," Calarco said. "It's impacting people's access to care because they can't afford the $75."

Suffolk runs eight clinics, two of which -- East Hampton and Southampton -- are being consolidated and privatized. Visits fell from 274,602 in 2010 to 187,955 in 2012, a 31.6 percent change.

One of the busiest locations, the Tri-Community Health Center in Amityville, saw a 42 percent decline in visits, records show.

Health Commissioner James Tomarken said the drop isn't tied only to the fee system changes. The prime factor was last year's $8.6 million cut in state aid for the clinics, which forced reduced hours and fewer visits, he said.

The health department will study Calarco's proposal, but Tomarken said the idea of lower patient fees is one of the reasons Suffolk is pushing to turn more of its health centers over to a private operator. At the Elsie Owens Health Center in Coram, which last year became the first county clinic to be privatized, most uninsured patients pay $15 per visit.

"This bill is reinforcing our position to make the health centers as affordable as possible, not only to the patients, but also to the county," Tomarken said.

Privatization of the South Fork clinics should be completed by year's end, Suffolk officials said. County Executive Steve Bellone in his 2014 budget may propose turning over the operations of more locations to his preferred private operator: Hudson River Health Care Inc. of Peekskill.

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That effort is likely to make the administration balk at altering county clinic operations. But Calarco doesn't want to wait: "The single person making $20,000 a year, who would not qualify for Medicaid, is being charged the same rate as the person making over $40,000 per year, simply because they do not have a copy of their birth certificate, or Social Security card."

Advocates for Suffolk's working poor support the effort.

"In these tough economic times, even a $75 co-pay can stand in the way of someone getting the care they need," said Theo Oshiro of Make the Road New York, a Latino advocacy and support group.

Calarco's bill will be considered at the legislature's Sept. 11 health committee meeting.

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