More than eight months after UCSF/Mount Zion Medical Center got serious about weaning 840 uninsured Russian emigres from its care, the state has come to the rescue.
"About 80 percent" of the emigres, who were caught between disappearing Jewish community funds and elusive government aid, have qualified for Medi-Cal coverage in recent months, a UCSF/Mount Zion administrator said this week.
The plight of the 840 Jewish emigres first became public last June. That's when the S.F.-based Jewish Community Federation turned down a request for $219,000 to help cover outpatient health-care costs for the emigres while they were transferred from the former Jewish hospital into the city's care.
Once the federation turned down the request, UCSF/Mount Zion staff began looking into other sources of money.
UCSF/Mount Zion staff had been "so busy taking care of these people that there was just not the time to sit down and evaluate" the Medi-Cal option, said Ann Lazarus, head of Mount Zion Health Systems, a nonprofit that funnels Jewish contributions into UCSF/Mount Zion programs.
"Plus there was philanthropic support. So it was only when [the JCF] said they can't pay any longer that [Mount Zion staff] sat down to evaluate."
The 840 ex-Soviets were originally covered by Medi-Cal, which is granted for eight months to all legal immigrants.
Most, though not all of them, have now requalified for Medi-Cal and will remain in the care of UCSF/Mount Zion doctors.
About 20 of them with more serious health problems requiring intensive treatment are now receiving city-funded care through San Francisco General Hospital, said Anne Marie Kneuker, a manager in UCSF/Mount Zion's outpatient department.
The status of another 13 percent of the 840 is unknown because they have not returned for medical care after their initial Medi-Cal coverage expired, she said.
In addition, a few private doctors affiliated with UCSF/Mount Zion have offered to provide pro bono care for any emigre who couldn't get the Medi-Cal coverage.
Thousands of ex-Soviet emigres have successfully navigated UCSF/Mount Zion and the Jewish communal network on the road to financial independence and employer-sponsored health benefits. But upward mobility has been out of reach for this group of 840. They are mostly unemployable, have health problems and aren't old enough to receive Medicare.
As the emigres' original Medi-Cal coverage lapsed, they continued to receive outpatient medical care at UCSF/Mount Zion with subsidies paid in part by the S.F.-based Jewish Community Federation, which helped them relocate to the Bay Area.
In recent years, JCF officials have said that they want to help all ex-Soviets make a new start, but that their longterm obligation to them has its limits.
At about the same time, UCSF/Mount Zion began working toward a merger with the Stanford University medical group. The 1997 reorganization was the decisive nudge for the hospital to consider the transition the emigres to city-supported medical services.
A hospital task force assembled in late 1997 to study the matter. Its findings called for a gradual phasing out of care for the emigres as caseworkers guided the ex-Soviets into city-sponsored health care.
However, UCSF/Mount Zion declined to foot the bill for that plan, prompting Mount Zion Health Systems to ask the JCF for an additional $219,000 as part of the 1999 budget.
The task of soliciting and channeling federation funds for programs at UCSF/Mount Zion Medical Center is part of Mount Zion Health Systems' raison d'être. The agency also manages all Jewish donations to the hospital that preceded its merger with UCSF in 1990.
Though it turned down the request for $219,000, the federation did approve an annual allocation of $65,000 for the care of all emigres at the hospital. The extra $219,000 would have paid for 12 months of medical care during the transition.
"We told the federation that we needed them to be a partner for one or two more years and then it's off their hands," Lazarus said.
After pleas from UCSF/Mount Zion's top administrator, the federation agreed to pay an extra $81,000 toward the salaries of caseworkers who would ease the transition into the city's care.
This week, JCF officials said that the request for $219,000 was simply too high.
"We have kept the safety net intact" with the additional allocation of $81,000, said Rick Crane, interim director of planning at the JCF and a former administrator at UCSF/Mount Zion.