Santa Fe County commissioners will make a decision today that could affect several countywide health programs.

The county annually provides millions of dollars worth of Sole Community Provider funds to Christus St. Vincent Regional Medical Center to pay for services the hospital provides to county residents who can't pay.

That money is used by the hospital to garner millions more from federal sources that require community matches.

The county is obligated to maintain a certain level of funding each year, which is directly related to the amount of care provided to indigent county residents. But the county can, and has, contributed more than the minimum in the past to help the hospital obtain more federal matching money.

The base amount the county is obligated to provide is about $5 million.

Last year, Santa Fe County committed to paying about $9.5 million, but ultimately didn't because the hospital got about $4 million worth of stimulus money to offset the difference.

But this year, no stimulus money is expected and commissioners must decide whether to contribute the base amount — which would deprive the hospital of the ability to obtain substantial federal matching funds — or to pay more, which would strain the county's own budget.

County Manger Roman Abeyta said the hospital is asking for $8.4 million this year. But because of falling tax revenues, Abeyta said, the county can't afford to pay extra this year without cutting county-run health programs or having the hospital take over those programs.

"We can't do both," Abeyta said.

Programs that could possibly be cut or absorbed by the hospital include the county's mobile health van, which provides routine screenings, vaccinations and information throughout the county, and The Sobering Center, which provides detox and substance-abuse counseling services.

The health van costs the county about $227,000 per year. The Sobering Center costs about $880,000 per year.

Commissioner Liz Stefanics said medical care for Santa Fe County inmates is another program that could potentially be taken over by hospital staff if the county agrees to pay more in Sole Community Provider funds.

Santa Fe County and the hospital have struck such bargains in the past.

But, Stefanics said, issues with transparency (the hospital is not subject to open-government laws) and accountability prompted the county to resume operating some of its own programs and revert to donating the base amount of Sole Community Provider funds.

The funding issue will be discussed and possibly voted on today during a meeting scheduled at 1 p.m. in the Commission Chambers at the Santa Fe County Administration Building, 102 Grant Ave.

Contact Phaedra Haywood at 986-3068 or phaywood@sfnewmexican.com.