Thousands of patients come through the Del Paso Health Center each year. Patients like Sylvia Butikofer. She has diabetes and says she does what she can to manage the disease.

“I eat a lot of fresh fruit, and vegetables and eat healthy.” 
 
But Butikofer says she also needs help from a doctor. She’s 59 and lost her job in the food service industry about eight months ago. Butikofer relies on her regular visits to the clinic to monitor her diabetes. But now the clinic will be open only a few days a week and it will be harder to get in. She also gets her care through a special diabetes program. And that will be dramatically scaled back as well.

“If they don’t get you a check-up they don’t give you the medicine, so that’s what it is and I need my medicine, I take five different medicines for my diabetes.” 
 
She’ll still get her medicine but her condition will not be watched as closely. And that’s a problem according to Dr. Keith Andrews. He heads Sacramento County’s Primary Health Services.

“My biggest fear for these patients, who I’ve been taking care of for nearly 10 years, is that patients who have chronic illness will suffer complications because they’re not being addressed in a systematic way that we were trying to do with our chronic disease management clinics.” 
 
Andrews says other programs for chronic diseases like hypertension or asthma will also be cut deep. That affects thousands of patients. The clinics provide basic medical care for the working poor. They’re usually adults who don’t qualify for the state public health program, Medi-Cal. He says when the Del Paso center is open part time, patients might have to go to another clinic. And Andrews says that could be difficult.

“I would imagine that someone would have to spend up to three or four hours on public transportation, so you could easily spend a day just to get a doctor’s office visit.” 
 
And when they do get there Andrews says it will take even longer. He says two years ago there were six clinics to serve the more 50,000 patients a year. Now the county will be down to two and a half. And, he says demand is up by about 10 percent because of the recession.

Andrews: “There’s no doubt that with these clinic closures that patients are going to have to wait longer.” 
 
Yee: “We don’t have the money and I can’t resolve it.” 
 
That’s Sacramento County Supervisor Jimmie Yee. He’s on the board that’s cut the Del Paso Health Center down to a bare bones operation. He says the board was considering completely closing the clinic but was able to salvage some services.

“As much as I support keeping the clinics open we have to face reality, I’m not pleased with it, but you can only do what you can.” 
 
Yee says the county’s top priority was preserving public safety so that meant more cuts to health services. But, he hopes to restore them with some federal aid.

“Eventually maybe in August, September, October the latest, we might be able to get some stimulus funding for us so that we can go back and take a hard look at re-funding some of these clinics.” 
 
In the meantime Sylvia Butikofer is trying to figure out how she’ll get to the doctor for her diabetes care.

“Well I have no idea where I’m going to go because I’m unemployed right now, so I’ll take it day by day.” 
 
But if you have a chronic disease or live far away from the few clinics left…accessing health care could be a challenge.