When it comes to care shortages in Central Valley, the story went from bad to worse for patients

Finding a consistent primary care doctor, clinic or specialist to get health care services in California’s Merced County is a struggle for most people. With about 51 percent of the county’s population on Medi-Cal, California’s Medicaid program, a large number of patients depend on rural health clinics for care. As I began a six-month reporting journey on the challenges of finding care in the county, it became clear to me that health access was going to get worse before getting better.

The main thing I learned throughout my reporting process was it’s OK if the story changes while you’re reporting. My project took a huge turn and ended up being a lot different than what I thought it would be. For me, this was the biggest challenge.

Originally, I thought the three stories I ultimately published in the Merced Sun-Star would take a deep dive into the health care system that Medi-Cal patients in Merced County are forced to navigate, hoping it would give me the answers to a question I’ve been asking since I began reporting in the Central Valley — why is it so hard to find a doctor?

My six months of reporting brought me to a worrying conclusion, one that didn’t look so promising for many of the 255,793 people in Merced County.

In those six months, a health clinic based in Merced, Horisons Unlimited Health Care, fired and sued it’s long-time CEO for misuse of funds, filed for bankruptcy, closed the doors of all eight clinics and was under investigations by seven different agencies, including the U.S. Department of Justice and FBI.

With the closure of all eight Horisons clinics, other clinics in Merced County were seeing a huge influx of patients in their already overcrowded waiting rooms. So where do the thousands of patients, 80 percent of which were on Medi-Cal, go for care now?

Trying to answer that question brought me to another roadblock: Nobody wanted to talk about this issue. Dozens of calls and emails over several weeks to Horisons employees and lawyers weren’t returned, so I had to figure out a way around it.

And it wasn’t just me they weren’t talking to. Many patients couldn’t get ahold of their medical records and didn’t know why employees were being let go and appointments were suddenly being canceled.

The officials with the Central California Alliance for Health, the group that oversees Medi-Cal services in Merced County, didn’t really want to talk about the issue either. They only went as far to say that they were working with providers to ease the new burden and patients should reach out to them for help.

The more stories I published on the legal battles surrounding Horisons, the more patients and former employees began to contact me. A tip I have for future fellows: let real people (not just experts or administrators) tell the story. If I had kept trying to tell the story through the perspective of administrators, I would’ve never been able to do so.

The patients I spoke with drove a lot of the story, and most of the time I found their stories were what keep people reading and interested. Through talking to patients I was able to get a full understanding of what it’s like for people in the county to find a doctor, especially after the Horisons closure.

By this point, I wasn’t only looking at a county that had some of the highest rates of chronic diseases in California, but a county that has to figure out a way to accommodate all the patients that didn’t have a clinic to call “home” anymore.

I spent a lot of time trying to salvage the story I wanted to write and not enough time writing about the issues that were happening and impacting people in that moment, like the closure of the clinics.

But just because the story isn’t what you thought it would be, it doesn’t mean it’s not developing into another equally powerful one.

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