It’s about to get a lot tougher for hundreds of struggling health clinics that rely on Medi-Cal reimbursement to help keep the lights on.

The state’s seven week delay in approving a budget means reimbursement money has dried up, so instead of a getting the usual Medi-Cal check this week, clinics will get a letter saying, in effect, “We owe you money, we can’t pay you yet, but please keep seeing patients.”

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Sean South, with the California Primary Care Association, says a lot of these clinics operate on the narrowest of margins and the Medi-Cal payments can make or break them.

“When you don’t have the cash reserves that you need in a situation like this, I mean how do you replace 50 to 80 percent of your income and survive,” he said.

John Gressman, the CEO of the SF Community Clinic Consortium which helps fund Clinics like the Haight Ashbury Free Clinic, Glide Health Services and Mission Neighborhood Health Center, says he will do what he needs to do to keep primary care going. That might mean some layoffs and forgoing health education and case management.

Some clinics have mentioned deferring payment to vendors or even looking at private loans.


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