By Megan Baier
HealthyCal.org correspondent
Megan Baier
The Elizabeth Center for Cancer Detection in Los Angeles — one of the oldest cancer screening clinics in California — plans to shut down today after treating its last patients.
The center is a victim of Gov. Arnold Schwarzenegger’s decision to freeze enrollment in a cancer screening program for low-income women on Jan. 1 and pay for routine mammograms only for women after the age of 50. Those moves caused an abrupt drop in the Elizabeth Center’s patient load and revenues, which had already been strained as its costs exceeded what it was earning from the state.
Founded in 1944 by Elizabeth Mason Hohl M.D., the Elizabeth Center’s mission has centered on prevention and early detection of breast cancer since its inception. The Center has served over 750,000 women — most of them low-income — over its 66-year history.
The Every Woman Counts (EWC) program pays for mammograms and cervical exams for low-income women who are underinsured or uninsured. Nearly 9 out of 10 patients treated at the Elizabeth Center were covered by that one program. In 2009 alone 13,000 women received mammograms at the center.
Medi-Cal reimbursements are lower than reimbursements from private insurance companies and because of the high proportion of patients treated at the Elizabeth Center who are not privately insured, the Center has had to find other sources of income to supplement the reimbursements it got from the state Medi-Cal program.
The Elizabeth Center owned and sold property at 3rd and Loma in Los Angeles in the 1990s and moved to a single location at 1127 Wilshire Blvd, near the Good Samaritan Hospital just west of downtown. The money the center made off the sale of those properties has been providing additional funding to the center since 1997.
Donald Cook, the Executive Director of the Elizabeth Center, said he knew the center could not continue on the path it was on, even before the crisis brought on by the governor’s decision to freeze enrollment in the program that was the center’s major source of income.
“We knew three to four years ago,” Cook said. “We need to get out of this box. We are too dependent on Medi-Cal”.
Cook and the Center’s directors looked for funding elsewhere, from the Los Angeles County Board of Supervisors to the state and all the way up to the federal government, but were not able to get assistance.
If the Center were going to stay open, it would have to serve a smaller proportion of women insured by Medi-Cal or the Every Woman Counts program and a larger proportion of privately insured women.
“We have got to change to 25 percent Medi-Cal, not by eliminating low-income women, but by bringing in insured women” Cook said.
The eligibility changes that took effect Jan. 1 severely limited the population that could access the Elizabeth Center’s mammogram services. So far in 2010, the volume of patients the center serves is down 60 percent, Cook said.
Since January, the Elizabeth Center has been paying more and more out of its own reserves to stay open and has run out of money to do so any longer.
The closure is likely permanent, Cook said.
“It would take a miracle to stay open,” he said. Cook estimates it would take about $2 million for the center to reopen, but once equipment is sold and staff are gone, that prospect is very unlikely.
The Elizabeth Center’s mission is to catch breast cancer in its early stages, while patients have a high survival rate. Cook says, “Early detection is our best weapon today and will be for a long time.”
While the Elizabeth Center may be the first cancer screening clinic to close its doors, the enrollment freeze in the Every Woman Counts program its taking its toll throughout the state.
Deb Weintraub of Susan G. Komen for the Cure in Los Angeles county said the cuts to EWC have resulted in an increasing number of low-income women going with out screenings.
“Ultimately it will cost the state more money,” she said, since decreased access to mammograms will likely result in cancer being caught in later stages when treatment is more expensive. “Prevention is so much more cost effective.”
“Access for proper health care in LA county is disappearing,” Weintraub said, and “really it is the poor women of California who are losing out.”
