Chicago's next budget and its health services

Chicago's next budget and its health services

The future of the City of Chicago's health services network may come into focus during the city's upcoming budget season.

The Chicago Department of Public Health operates facilities for mental health patients and neighborhood medical clinics that offer a range of programming, from pregnancy testing to adult care.

Labor organizations that represent the city's health care workers and some community groups fear Mayor Rahm Emanuel's administration will seek to contract out health services to help close a more than $635 million gap in next year's city budget.

"I think this could be the year," Adrienne Alexander, a policy analyst for the American Federation of State, County and Municipal Employees Council 31, said at Emanuel's August 29 budget town hall meeting.

Alexander argued privatizing services would result in reduced access to care for low-income patients, forcing them to seek medical care at emergency rooms instead of clinics. Sliding-scale fees at federal qualified health centers, she said, present another barrier.

The Emanuel administration has set a clear policy preference bolstering federally qualified health centers, "public and private nonprofit health care organizations that meet certain criteria under the Medicare and Medicaid Programs," according to the federal definition, in Chicago.

The public health department's recently released Healthy Chicago includes a goal of increasing the number of patients using such centers by 50 percent, to 648,991 people, by 2020. The mayor's August 22 memo says the city will realize $20 million in savings this budget year through an "enhanced partnership" between the public health department and federally qualified health centers.

At the August 29 town hall, Emanuel was asked about contracting out services. He referenced studies of the Uptown and Englewood clinics. "The people in those two clinics on six measurements of health care got better service at about one hundred bucks savings per visit," Emanuel said. "So, five other community health care clinics, that's what we have, partnering with [a] federally qualified ... community health care manager. We have those people now running the seven--save $10 million and improve our health care outcomes."

Someone in the crowd then responded by saying privatized services would result in people getting turned away from care.

The future of the city's mental health clinics, meanwhile, remains vague.

At the August 29 hearing, Matt Ginsberg-Jaeckle, an organizer with Southside Together Organizing For Power, asked Emanuel "if you're going cut the mental health clinics budget as well" and, if so, "Are you going to make calls to all the people, who are losing children, as our violence continues to go skyrocketing because you're not providing the services?"

Dr. Bechara Choucair, head of the public health department, said, "We all know that we are dealing with a very, very tough budget year," he said. "But please be assured that access to mental health services for our most vulnerable in our community continue to be critical."

That answer did not satisfy one woman in the audience.

"They been going down since I've been going there!" she yelled.

A city public health spokesman had not returned an emailed request for comment about the Uptown and Englewood clinics, and two other questions, by The Chicago Reporter's deadline this afternoon.

UPDATE, 5:58 p.m.: Jose Munoz, a spokesman for the Department of Public Health writes in an email that "the cost of our services provided in our clinics was higher than the average cost of the same service provided by an FQHC," or federally qualified health center. Data from 2009, he said, show that FQHC visit costs came in at $128.18, while Department of Public Health visits were $223.07. He said the Englewood Clinic pilot is operated by a group called Community Health, while the Uptown clinic is operated by Heartland International Health Center. Munoz said the department has not put out any request for information about for contracting out women's and pediatric health care.

© Community Renewal Society 2011

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