Money woes are threatening to close a Scottsdale health clinic that acts as the primary care provider for 1,700 people, many of them low-income residents.
On Wednesday, the Maricopa County Board of Supervisors plans to vote on whether to shut down the Scottsdale Family Health Center in an effort to staunch the financial bleeding of the county's ailing health system.
The closing would affect people such as Aaron and Veronica Rios and their 19-month-old daughter, Esperanza.
The clinic is just a five-block walk for Veronica Rios to take the baby for a vaccination or medical help. Aaron Rios visits the clinic for regular check-ups and control of his diabetes, cholesterol and a rash on his legs — all of which are improving under the clinic's care.
"If I go and see another doctor I'll have to start everything over from zero," said Rios. whose family owns one car. "If something happens to my baby, I don't know how my wife will get to the doctor."
The possible closure is more than an upheaval for the families who use it. The closure stands as a warning for what might come of the county's health care system for the poor, said Brett McClain, vice president of ambulatory services for the county health system for the poor, Maricopa Integrated Health System.
"Scottsdale Family Health Center is a microcosm of what is happening in the state right now," McClain said. "We are really viewed in the community as a safety net. That's great. That's part of our mission. Unfortunately we don't have any money to take care of the underserved."
The Scottsdale clinic is being considered for closure based on its $165,000 deficit last year, and after it was determined that there are currently 75 nearby private doctors available to clinic patients, McClain said.
The proposed closure has prompted cries of concern from Scottsdale officials, the nearby Scottsdale Healthcare Osborn hospital, and the clinic's patients, 400 of whom have signed a petition asking the board to leave the clinic doors open.
And the next few weeks will probably bring more clinic closings, said Supervisors Chairman Fulton Brock, R-District 1 of Chandler. Brock said he will vote in favor of closing the Scottsdale clinic.
The Maricopa Integrated Health System consists of the Maricopa Medical Center in Phoenix, a mental-health hospital, four health-insurance programs and 12 community clinics, including ones in Chandler, Mesa and Guadalupe.
"It's not absolutely improbable that the hospital (Maricopa Medical Center) won't close in the not-too-distant future," Brock said.
Brock said the hospital and clinics lose more than $2 million each week, and the county has set aside $53 million this year for possible shortfalls for the system.
Concerns about providing health care have become more urgent in the face of the July 1 sunsetting of a mandate which requires the state provide health care to its poor.
Like an emergency room, the clinic attracts many uninsured people. If these patients don't pay their medical bills, the clinic must assume the cost of their care.
That is one reason Scottsdale Healthcare Osborn hospital — whose emergency room is eight blocks from the clinic — is considering opening a family practice as replacement to the county clinic, said Wendy Lyons, vice president for strategic development at Scottsdale Healthcare.
"If all 1,700 (of the clinic's patients) show up in E.R., it's going be a big problem," Lyons said. "If the center closes, I think that's where people are going to migrate to."
Some patients say they will follow the clinic's long-time physician, Dr. Victor Alvarado, to the county's Chandler clinic.
One of these people is Shirley Duty, 73, who has been going to the clinic every three months for six years.
"I think this is a bad deal," said Duty, who is in a wheelchair. "A lot of people come because it's so close."
To save the clinic is to burrow deep into the roots of Maricopa Integrated Health System's financial woes.
Maricopa is the only county in the country without a tax source for hospitals, McClain said. To create a tax base, voters would have to pass a referendum to support it.
But before that could happen, the county would have to seize ownership of the the land on which Maricopa Medical Center sits. Lack of ownership of this land prevents Maricopa Integrated Health System from selling the facility, or forming partnerships which could benefit it. The county has filed a lawsuit against the state to win the title to that land.
Meanwhile, the Legislature has proposed tens of millions of dollars in cuts to the state health-care system, which pays for the majority of Maricopa Integrated Health System's services.
There are rays of hope. Sens. Jon Kyl and John McCain, both R-Ariz., on Thursday introduced a bill that would allocate $1.45 billion annually to states for uncompensated care for illegal immigrants. Arizona is designated to receive $235 million.
"What (uncompensated care for illegal immigrants) is doing is denying quality health care to Arizona citizens," Kyl said in a phone interview last week.
Money from the Arizona Legislature to save the system, however, is far less likely, said House health committee member Phil Hanson, R-Peoria.
Many involved in the county health-care program are putting their faith in the recently formed Citizen Task Force. The 10-member panel of health-care community members are meeting weekly to come up with innovative ways to better the health system, and keep the system afloat after July 1.