MASON — Ingham Community Health Centers have overspent this year by at least $4 million and leaders will be considering layoffs and closing some of their 13 health centers to resolve the financial crisis.
The community health centers fall under the Ingham County Health Department, and during a Thursday community health centers Board meeting, the health department's Chief Financial Officer Jennifer Mora and the centers' Executive Director Kris Drake presented several plans that would reduce the losses, which county officials have seen coming for months.
The most extreme proposal - about two dozen layoffs and five clinics closing - would only save $3.3 million, not covering this year's anticipated shortfall.
The health care centers in the county are expected to end the fiscal year, at the end of September, somewhere between $4 million and $4.5 million short, said Jared Cypher, Ingham County's deputy controller.
A county health board has scheduled an Aug. 8 meeting to make a recommendation on whether to adopt layoffs and closings. It will happen two days after what county officials say is an unrelated vote on an existing but paused millage that funds a plan for general health care benefits and mental health care benefits for many low-income residents.
Here are the four proposals so far:
- Laying off 11 full-time and 3 part-time employees and eliminating two vacant full-time positions to save $1.1 million
- Laying off 15 full-time and 3 part-time employees and eliminating two vacant full-time positions to save $1.8 million
- Laying off 18 full-time and 3 part-time employees, eliminating two vacant full-time positions, and closing Sexton, Gardner, Everett and Pattengill clinics to save $2.6 million
- Laying off 22 full-time and 3 part-time employees, eliminating two vacant full-time positions and closing Sexton, Eastern, Gardner, Everett and Pattengill clinics to save $3.3 million
These figures were provided by Ryan Sebolt, the chair of the Ingham County Board of Commissioners, who was able to get a copy of the health department's proposals late Friday.
Dr. Nike Shoyinka, the medical health officer who oversees the broader health department as well as the centers, said she was not able to confirm the details of the proposals.
She said the proposals were not intended to be raised in detail during the Thursday meeting but were printed, based on previous internal recommendations, during the meeting at the request of the board and also that community health center board members had been provided with the proposals prior to Thursday.
County decisions
The full Ingham County Board of Commissioners would ultimately decide on any savings plan.
Sebolt, a Lansing Democrat, said the health department has been aware of the shortfall for months and he spoke during a public comment portion at a meeting about a month ago to make sure the health board members were aware of the looming financial cliff.
He said county residents and county officials have repeatedly committed to giving access to health care.
"We are going to do everything we can to make that doable, with an emphasis on making health care a priority," Sebolt said.
Sebolt said he and other county board members will take the health board's recommendations seriously and his preference is to retain staff as much as possible, with consolidating clinics being preferable to losing employees.
Shoyinka agreed the various solutions would not completely close the gap.
“We have been talking about this for some time,” Shoyinka said. “Earlier operations were looked at and a reassessment was done.”
Shoyinka said cost-saving measures at clinics were launched around March or April. She said she didn’t have specifics about the cost-savings moves that were made at that time.
“The ultimate goal is we’re able to keep the doors open, in any way we can, to keep our responsibility to the community,” Shoyinka said.
'Not sustainable'
Cypher said the anticipated shortage of $4 million or more will likely need to be covered at least partially by the county's rainy-day fund, which had around $9 million last year.
"That is, of course, not sustainable," he said.
The Community Health Centers has a 2024 budget of $35 million , with $5.2 million of that money coming from the county's general fund. Mainly located in Lansing, the clinics act as small hospitals or medical offices, and they get the bulk of their funding from Medicaid and insurance plan payments.
The county's health centers also serve people without insurance. Patients are not turned away for lack of coverage, which can mount losses.
The county spends at least $60 million on health a year . Aside from the clinics, that spending includes maternal health ($6 million), administration and immunization (around $3.3 million each), environmental health ($3 million) and various other programs including public awareness efforts and disease control.
Cypher said the community health centers fell short by more than $1 million last year and the larger shortfall this year is significantly tied to fewer Medicaid patient visits.
The county's health care centers receive federal dollars for each Medicaid visit, an incentive for accepting Medicaid and additional money when compared to other visits, he said. The department anticipated around 105,000 Medicaid visits this year but there have been around 62,000 visits, meaning significantly less federal money is ending up at the centers, Cypher said.
A health care ballot issue is coming
On Aug. 6, during the primary election, counter voters also will decide whether to renew a millage that supports the Ingham Health Plan .
Sebolt said the two issues - the community health centers' shortfall and the health care plan - are not related, and a renewal of the health plan would not help address the deficit of the health centers.
The IHP functions as a light version of health insurance for thousands of low-income residents - those who make 250% of the poverty level or about $37,650 for a single person and approximately $75,000 for a family of four in Michigan.
The health program covers many basic needs , like office visits, diagnostic tests, physical therapy, surgery and urgent care. It is not, however, an insurance plan and does not cover some potentially costly issues like emergency rooms, chemotherapy, ambulances or dialysis.
Some of the people who go to the community clinics will have the Ingham Health Plan, but the clinics also serve Medicaid and private insurance patients as well as those without insurance.
Contact Mike Ellis at mellis@lsj.com or 517-267-0415 .
This article originally appeared on Lansing State Journal: Ingham County health centers face layoffs, closures with $4 million shortfall
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