Stanislaus County letting go of health clinics for the poor. What’s happening with them?

The Stanislaus County Health Services Agency is proposing to turn over operation of a west Modesto health clinic to Golden Valley Health Centers as the county continues to reduce its health services for low-income residents.

The county agency also proposes to close its specialty clinic in the black-glass building on McHenry Avenue and stop providing physical rehabilitation services for the poor.

The county once was a major part of the health care safety net for the county’s poorest residents but appears to be on track to completely relinquish that role. About 14% of the county’s population lives below the poverty line and close to half rely on the state’s Medi-Cal system for their health care.

For years, the county’s Paradise Medical Office, on Paradise Road, has provided access to healthcare for Modesto residents living west of Highway 99. It has almost 10,000 patients.

Golden Valley, a Merced-based nonprofit with a growing number of clinics in the Northern San Joaquin Valley, could begin operating the west Modesto clinic in July. The proposal is expected to be on the Board of Supervisors agenda Tuesday, asking the board to set a public hearing for April 16.

While the Paradise clinic could simply change from one provider to another, less is known about the ramifications of closing the county’s medical specialty clinic and rehab services. The county hasn’t decided whether an immunization clinic next to the Paradise office will remain in that location.

Dr. Silvia Diego, a former medical director for Golden Valley and a member of the state medical board, said the shrinking county health system is not a good development for the underserved in Stanislaus County.

“I am very saddened to see that another big provider of healthcare for the poor and underserved is closing their doors,” Diego wrote in an email. “It shows the great need that we have in the Central Valley for primary care providers and more so in our area, where the most vulnerable patients live. The system of healthcare is shrinking and that’s really what we need to take a look at as a community.”

The county’s Paradise clinic is a primary teaching site for family practice resident physicians trained through the Valley Consortium for Medical Education. The Health Services Agency proposes to turn over that role to Golden Valley Health Centers, along with the role of providing primary care for patients in west Modesto’s disadvantaged neighborhoods.

Mary Ann Lilly, director of the HSA, cited several reasons for turning over another safety-net clinic to an outside provider.

She said changes in state law and the Medi-Cal program, going back 15 years, have altered the purpose of the county Health Services Agency, which once had seven clinics serving the county’s poorest residents.

After shedding the Paradise Medical Office, the county will have the McHenry Medical Office on Woodrow Avenue and the Family and Pediatric Health Center on Scenic Drive. The county Health Services Agency will focus resources on patient care teams and care management and also explore opportunities that arise through Medi-Cal reforms, a news release said.

The county news release Tuesday also said the Health Services Agency no longer would provide care for high-risk pregnancies, physical rehab and specialty services, effective July 1.

Drug use, poverty and health access issues elevate the rate of difficult pregnancies and premature births in the region.

Lilly noted that Golden Valley and county health services have been providing care for high-risk pregnancies, sometimes using the same obstetricians. “That change should be neutral in terms of the community,” Lilly said. “We have the opportunity to refer (patients) to Golden Valley’s resources.”

Women’s health and pediatrics will still be provided at the county’s McHenry Medical Office.

Clinic staying open matters more than who runs it

Perfecto Munoz, chief executive officer for the West Modesto Community Collaborative, said that so far, he hasn’t heard many concerns about Golden Valley absorbing the Paradise medical clinic. He said the main issue for the community is that the clinic stays open.

“The value of Golden Valley being there is keeping the operation going,” Munoz said. “Without them, many of those families that go to the clinic would have to find services farther away from home.”

He said many people walk or drive a short distance to the family-oriented clinic. “This is a good opportunity for Golden Valley to give them a big footprint in the heart of an underserved community,” Munoz said. “And it’s a plus if they offer other kinds of services as a federally qualified health center.”

Munoz said he hopes the county will maintain some oversight to ensure the healthcare at the Paradise clinic meets the same standards. He added that the county has begun to hold meetings to inform the community. He said Golden Valley should reach out to make connections.

Will the clinic add services?

Dr. Carrie Janiski, regional medical director of Golden Valley, said without a doubt the Paradise clinic will remain open after the county pulls out.

“We plan to continue all services that are currently offered and will absolutely have discussions around other services than can be offered at that location,” Janiski said. In addition to primary care, Golden Valley’s system of health centers has vision and dental services, podiatry, mental health services, cardiology and care for allergies and kidney disease.

Representatives said the switch from county to Golden Valley operation could be done without a temporary closure of the west Modesto clinic or interruption of services.

Janiski said Golden Valley became a financial supporter of the Valley Consortium for Medical Education some years ago and began the process last year of hosting a teaching site for the family practice residents at a McHenry Avenue clinic. Now that there’s a proposed agreement with the county, Golden Valley thinks it is best for the medical residents to keep training at the Paradise clinic.

County leaders could approve the agreement with Golden Valley after a public hearing next month.

County Supervisor Terry Withrow, who represents west Modesto, said the proposal should be positive for health care in the area. “Golden Valley will be able to provide more services and more physicians,” Withrow said.

The county Health Services Agency will have to satisfy bargaining obligations with union-represented staff at the Paradise clinic. Affected staff members will be offered other positions with the Health Services Agency.

In 2019, the county system of health clinics contracted when the Turlock and Hughson facilities were outsourced to Livingston Community Health and Golden Valley took over the county’s clinic in Ceres.