Request

Vote Health is seeking County funding for FY 2001-02 to improve waits at ACMC for specialty clinic appointments, which can take up to six months. Shorter waits would obviously improve care, and could make the Medical Center more competitive with private providers, boosting revenues.

Vote Health requests that the County allocate $2.5 million to increase staffing in the ACMC specialty clinics.

Background

Alameda County Medical Center provides outpatient care in over 30 medical and surgical specialties. ACMC's outpatient specialty clinics are in great demand because they are the ONLY source of specialty care for uninsured residents of Alameda County. In addition, they are a vital source of care for the Medi-Cal population, which also faces limited providers in many specialty areas.

The specialty outpatient clinics at Highland and Fairmont Hospital are offered on only a part-time basis, with many clinics running just one or two four-hour sessions per week. Yet the waiting lists for these clinics indicate huge unmet need. Waiting times to get an appointment typically run several months, with waits of up to six months in numerous specialties. Clearly, the demand for these clinics, demonstrated over years of statistic collection by ACMC, is undisputed. Yet, budget limitations have kept them operating on a limited schedule while medical treatment for serious health conditions in the highest risk population is delayed.

The inaccessibility of these clinics is harmful to the uninsured population of Alameda County, because these patients have no alternative source for this care. It is also harmful to the long-term financial survival of ACMC, because ACMC cannot secure contracts to provide care to insured patients without meeting community standards for waiting times. Many health plans require that a patient be able to see a specialist in any needed specialty within two weeks. With waits for appointments in most ACMC clinics in the 12- week range, ACMC will never be able to diversify its payer mix.

The Medical Center has taken steps to try to improve the specialty clinic access crisis. With the help of a $1 million federal grant it has upgraded computer systems and processes for appointment setting. New staff have been hired in Central Appointments and Registration to triage patients more effectively. It has placed a limited number of specialties at Eastmont Wellness Center.

However, these efforts don't come close to solving the crisis for access to specialty care. There simply is not enough capacity in the clinics to meet demand. A new computerized appointment system cannot make a clinic that runs one day a week adequate to handle a patient load needing five days of service. The Medical Center is seeking $2.5 million for expanding access to specialty care. It is no longer clear that the Alliance is prepared to consider this request.

The most urgent need is for additional clinician time and extra nursing and other support staff. Until the new clinic space in the Critical Care and Clinics Building becomes available, there are still things the Medical Center can do with adequate funding to make specialty care more accessible:

• Existing clinic hours of operation could be expanded to later afternoons, evenings and Saturdays.
  


• More sessions could also be added at the freestanding health centers and at Fairmont Hospital.
  


• More providers could be hired in the various specialties to see patients during the hours the clinics are already open.

We believe that with this funding specifically targeted to increase specialty clinic staffing, this long-term crisis in access to care in our community can finally be improved.

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