Copyright San Diego Union-Tribune
San Diego County’s social services could soon be expanding into a new frontier — primary care. A plan from Supervisor Monica Montgomery Steppe, approved Tuesday by her colleagues, calls for exploring how the county could hire volunteer doctors and other medical staff to see patients at social services offices. Still in its early stages, Montgomery Steppe’s proposal calls for free medical care, including prescription drugs, to be provided to people who lose Medi-Cal benefits or face ineligibility under new rules for Medicaid. Since the passage in the summer of President Donald Trump’s domestic policy package, Democratic supervisors have worked to shore up social services like food access and health care. They’ve also examined how the federal legislation — which adds work requirements for some people who use Medicare and food benefits — will impact the county’s budget. “We cannot wait only to wish that we had done more while our emergency rooms are at risk of becoming overwhelmed due to their mandate to care for people who show up,” Montgomery Steppe said at a press conference on Monday. Under her plan, the county’s network of Live Well centers would be prime sites to house clinics and pharmacies for those unable to access public health care coverage. But the county does not have the money to fully staff them with medical professionals. Part of Montgomery Steppe’s plan calls for county staff to study how it can incentivize doctors and other health care workers to staff the clinics — for instance, by letting them use their work in the clinic to satisfy continuing medical education requirements from medical licensing boards. Her vision for the clinics would go beyond health care. The sites would pair health care with a food bank, relying on local grocers, restaurants and other food providers to donate food. In an interview, Montgomery Steppe called the effort a “really unique proposal” for something she hasn’t seen elsewhere. “The medical field is highly regulated,” she noted. “There’s a lot of regulatory requirements and things that we have to weave through. So we’re looking forward to digging in and doing that work.” Supervisors passed the measure on Tuesday, with Supervisor Jim Desmond casting the only vote against it. With its passage, county staff have 45 days to study how the county could prop up the clinics and how they would be paid for and staffed. Within 90 days, the county has to draft an action plan for implementing the program. The plan’s emphasis in part on food access comes as food programs for low-income people have come under new threat during the ongoing government shutdown. On Tuesday, supervisors also unanimously passed a measure calling on the federal government to immediately start paying SNAP benefits, also known as food stamps. Payments for SNAP, the Supplemental Nutrition Assistance Program, have lapsed, threatening benefits to 42 million Americans, among them 400,000 people in San Diego County. Over the weekend, a federal court ordered the Trump administration to pay SNAP benefits in some form, and the administration said it planned to provide half as much food aid as recipients would normally get this month. But on Tuesday, Trump threatened to withhold all benefits until the shutdown ends, an announcement his administration walked back later in the day.
