Ingham County health centers struggling with layoffs and closures, leaving $4 million in deficit

MASON — Ingham Community Health Centers has overspent by at least $4 million this year, and leaders are considering layoffs and closing some of its 13 health centers to help solve the financial crisis.

The health centers fall under the Ingham County Department of Public Health. During a health center board meeting Thursday, Jennifer Mora, the health department’s chief financial officer, and Kris Drake, the center’s director, laid out a series of plans to mitigate the losses that county officials have been anticipating for months.

The most extreme proposal — about two dozen layoffs and the closure of five clinics — would save just $3.3 million, which would not cover this year’s expected shortfall.

According to Jared Cypher, deputy controller of Ingham County, the county’s health care centers are expected to end the budget year with a deficit of between $4 million and $4.5 million at the end of September.

A county health board has scheduled a meeting for Aug. 8 to make a recommendation on whether to accept layoffs and closures. It will come two days after what county officials call an unrelated vote on an existing but suspended tax levy that funds a plan for universal health care benefits and mental health benefits for many low-income residents.

These are the four proposals so far:

Layoffs of 11 full-time and 3 part-time employees and elimination of two vacant full-time positions to save $1.1 million
Layoffs of 15 full-time and 3 part-time employees and elimination of two vacant full-time positions to save $1.8 million
Layoffs of 18 full-time and 3 part-time employees, elimination of two vacant full-time positions and closure of the Sexton, Gardner, Everett and Pattengill clinics to save $2.6 million
Layoffs of 22 full-time and 3 part-time employees, elimination of two vacant full-time positions and closure of the Sexton, Eastern, Gardner, Everett and Pattengill clinics to save $3.3 million

Those figures were provided by Ryan Sebolt, chairman of the Ingham County Board of Commissioners, who was able to obtain a copy of the health department’s proposals Friday evening.

Dr Nike Shoyinka, the medical officer of health who oversees the broader health department and the centres, said she could not confirm details of the proposals.

She said the proposals were not intended to be discussed in detail at Thursday’s meeting, but were being published at the board’s request based on previous internal recommendations. She also said the health center’s board members had been informed of the proposals before Thursday.

Decisions of the province

The full Ingham County Board will ultimately decide on any potential savings plan.

Sebolt, a Lansing Democrat, said the Department of Health and Human Services has known about the shortage for months. He spoke at a meeting about a month ago to make sure health care officials were aware of the looming financial crisis.

He said residents and officials in the province have repeatedly committed to providing access to health care.

“We are going to do everything we can to make that happen, with an emphasis on prioritizing health care,” Sebolt said.

Sebolt said he and other county officials will take the health board’s recommendations seriously and that he prefers to retain as much staff as possible, with merging clinics preferable to losing employees.

Shoyinka admitted that the various solutions would not completely close the gap.

“We’ve been talking about this for a while,” Shoyinka said. “Previous surgeries were reviewed and a reassessment was done.”

Shoyinka said cost-saving measures at clinics were launched around March or April. She said she did not have details on the cost-saving measures being implemented at that time.

“The ultimate goal is that we can keep the doors open, in whatever way we can, to maintain our responsibility to the community,” Shoyinka said.

‘Not sustainable’

Cypher said the expected shortfall of $4 million or more will likely have to be covered at least in part by the region’s emergency fund, which contained about $9 million last year.

“That is of course not sustainable,” he said.

The Community Health Centers have a budget of $35 million for 2024, of which $5.2 million comes from the county’s general fund. The clinics are primarily located in Lansing and operate as small hospitals or medical practices. The majority of their funding comes from Medicaid and insurance plan payments.

The county’s health centers also serve people without insurance. Patients are not turned away because of a lack of coverage, which can lead to huge losses.

The county spends at least $60 million annually on health care. In addition to clinics, that expenditure includes maternal health ($6 million), administration and immunization (about $3.3 million each), environmental health ($3 million), and several other programs, including public awareness and disease control.

Cypher said community health centers were short more than $1 million last year and that the larger shortfall this year is largely due to lower Medicaid patient visits.

The county health centers receive federal dollars for each Medicaid visit, an incentive for accepting Medicaid and extra money compared to other visits, he said. The department expected about 105,000 Medicaid visits this year, but there have been about 62,000 visits, meaning significantly less federal money is reaching the centers, Cypher said.

There is a health care vote coming up

On August 6, naysayers in the primary will also decide whether to extend a tax that supports the Ingham Health Plan.

According to Sebolt, the two problems — the shortage of community health centers and the health plan — are unrelated and revamping the health plan would not help address the shortage of health centers.

The IHP serves as a lightweight version of health insurance for thousands of low-income residents — people earning 250 percent of the poverty line, or about $37,650 for a single person and about $75,000 for a family of four in Michigan.

The health program covers many basic needs, such as office visits, diagnostic tests, physical therapy, surgery, and emergency care. However, it is not an insurance plan and does not cover some potentially costly items such as emergency care, chemotherapy, ambulances, or dialysis.

Some people who attend the community clinics have the Ingham Health Plan, but the clinics also serve patients with Medicaid and private insurance, and people without insurance.

Contact Mike Ellis at [email protected] or 517-267-0415.