Family Health Clinics Prepare to Cut Services

Orange County family planning operators are preparing to drastically reduce and possibly eliminate services in coming months as a result of state funding cuts, leaving thousands of poor women with inadequate health care, officials said.

Several clinics have cut back hours and trimmed staffs. Soon they will begin charging patients for services that used to be free.

At many clinics, women must now wait at least four weeks to get an appointment. Those waits are likely to increase, officials say.

County health providers fear the long-term impact will be an increase of unwanted pregnancies and, for many poor women, insufficient medical care.

“It’s a perfect example of those who can afford it getting private medical care and the poor going without,” said William Plumb, director of the Laguna Beach Community Clinic.

Health officials said that more than 55,000 Orange County women received services at 12 state-subsidized clinics last year. The officials estimate that 25,000 women served by the four county and eight privately run clinics could be affected in some way by the funding cuts.

Plumb said that many poor women rely on family planning services for basic care.

“Whether it is for contraceptives or Pap smears, these services are often a first line of defense against cervical cancer and other diseases,” Plumb said. “Poor women will be without that kind of checkup, and when they finally do discover their illness, it will be too late.”

As she waited for an appointment at the county’s Santa Ana clinic Tuesday, Sara Cortez, a 31-year-old Santa Ana mother of four who recently began using the clinic, said she has few other options.

Cortez said her husband’s construction job does not provide health insurance, so she had been paying a private physician to care for her children, ages 10, 9, 8 and 5. She sought out the Santa Ana clinic when the family could no longer afford the private care.

“It would be very detrimental to me and my friends if services here were cut,” she said. “Because of our income, we are limited in possibilities. We could not afford to pay again.”

The Laguna Beach clinic, which provides a complete range of medical services, lost 75% of its state family planning subsidy--from $44,000 last year to $11,000 this year, Plumb said.

Remaining funds will run out by mid-December, and the clinic will begin charging all patients for services. If patient fees do not cover costs, family planning services might be eliminated, Plumb said.

Marty Earlabaugh, director of the Huntington Beach Community Clinic, said her facility faces a similar crisis.

The clinic lost $200,000 in state funding this year, nearly one-third of its total budget. Several positions have been eliminated and others reduced to part-time in an attempt to reduce expenses, Earlabaugh said. The clinic has reduced its operating hours from 35 to 28 hours a week.

“It is very difficult for a small, free-standing agency to sustain a loss like that,” she said. “We expect our money to last through November, and then we will ask patients to pay for services. But we won’t know the full impact of our situation until that money is used up.”

Gov. George Deukmejian in July cut the state family planning budget nearly two-thirds, from $36.2 million to $12.1 million a year, despite entreaties from state and local family planning providers.

Deukmejian asserted that the rising rate of teen-age pregnancy in the state showed that the programs are not working and suggested that services would remain readily available.

Other state-subsidized clinics affected by funding cuts are the privately run Orange County Center for Health and the Coalition Concerned With Adolescent Pregnancy.

“When every agency is forced to eliminate so much, you can’t get (services) easily elsewhere,” said Barbara Jackson, public affairs coordinator for Planned Parenthood of Orange and San Bernardino counties.

Jackson said Planned Parenthood clinics have had to absorb at least 500 patients who were left without services after the Anaheim Counseling Center was closed in July.

The Anaheim center served up to 10,000 women and closed amid anticipation of reduced state funding, officials said.

Jackson said women must now wait three or four weeks for an appointment at the county’s four Planned Parenthood clinics.

Martha Bahena, a 19-year-old Santa Ana mother of a 2-year-old daughter, said such waits will mean more pregnancies for teens.

“If girls don’t get birth control, they will get pregnant,” said Bahena while waiting Tuesday to make an appointment at the county’s Santa Ana clinic.

Family planning services at the four county-run comprehensive health clinics have not been cut or scaled back yet, but officials said such cuts are likely.

The lost state funding represents nearly 30%--or about $412,000--of this year’s family planning budget, said Leonard Foster, deputy director of the county’s maternal and child care services.

Foster said the agency has been able to draw revenue from other health care activities to continue the previous level of family planning services.

And he said county officials still hope that the Legislature will restore some or all of the family planning funds, despite an unsuccessful effort to move lawmakers in that direction and the recent Bay Area earthquake, which will place even greater demands on the state budget.

“Until the Legislature completes its work, we are unwilling to make the drastic reduction in services that would be required,” Foster said.

If funds are not restored, county officials will consider a number of ways to scale back services but probably will not close clinics, Foster said.

“I have been with the county for 20 years, and this is the worst time I’ve seen,” said Julia Arriaza, a nursing supervisor at the Santa Ana clinic. “It is very scary. We all see the need of our clientele, and we can’t hide. They are going to be knocking at our doors.”