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Sea Mar puts expansion plans on hold

Employees hopeful downturn won't force staff reductions

By Brad Shannon | The Olympian • Published December 04, 2008

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The Sea Mar Community Health network had hoped to open another medical clinic for low-income patients in Lacey in the next six months to cope with a rising demand for care in South Sound.

But that plan is on hold for the time being. The same economic downturn that is giving chills to state and local government budgets is causing pain for community clinics that depend on the state to pay for a large share of their clientele.

"For Thurston County I think what we'll have to do is put on hold opening that second clinic until we see the impact of what the budget cuts will be," said Mary Bartolo, deputy director of clinics that Sea Mar operates in 10 Western Washington counties from Bellingham to Vancouver and out to the ocean coast. "In Thurston County, we don't want to do any cuts there because we already can't serve the need that is there."

In fact, Bartolo said Wednesday, Sea Mar served 10,000 separate patients with 37,000 office visits in 2007, and the numbers are likely to top that in 2008. More recently, Sea Mar has been unable to give appointments to all the patients it needs to see.

Patient Patricia Cox, a Lacey retiree, saw a doctor on Wednesday. Cox had a heart attack recently and was in for a follow-up visit with Dr. Angela Tobias.

Cox said she had difficulty finding a clinic that would accept her because she is on the federal Medicare program, but she is pleased with the service at Sea Mar. "Originally, I came to this clinic because I couldn't find a doctor. Now I come because I like the doctors," Cox said.

"I will never run out of work. I have constant anxiety that someone is going without something they need," Tobias said as she went to examine Cox. "I don't leave here until 7 p.m. most weekdays. I come in on weekends" for paper work.

Statewide, nearly 45 percent of patients seen by Sea Mar clinics are uninsured. In Thurston County the figure is closer to 24 percent with 55 percent covered by Medicaid or a state Healthy Options program. But a problem in Thurston County is that few doctors are taking those state funded patients or those on Medicare.

Bartolo said direct funding from the state is not the only concern clinics have as Gov. Chris Gregoire's budget writers look for ways to cover a $4.6 billion gap in the next two-year state budget without raising taxes. The nonprofit agency also has contracts with the state for drug-alcohol treatment, maternity support services and work it does in nutrition for mothers through the Women Infants and Children program.

With an expectation for less money, Sea Mar is looking at "cutting some services and programs, which could result in some staff cuts" in clinics in other communities. Thurston County won't get the new clinic, but it might be spared actual cuts — only because it already has so many underserved residents, Bartolo said.

"The demand in Thurston County is perhaps the greatest of all the counties we are in. There are people on Medicaid who can't get in to be seen" at private clinics, Bartolo said. "Our demand continues to grow down there on a daily basis. We've had to start limiting the number of new patients we can see."

About 12.5 percent of Thurston County residents were uninsured, according to a report issued last year by the Office of the Insurance Commissioner. That was just higher than the 11 percent state average.