When the Santa Barbara Neighborhood Clinics announced in May that it needed $1.5 million to stay open another six months, the community jumped in.
The three clinics on the Westside, Eastside and in Isla Vista serve almost 17,000 unduplicated patients every year for primary medical and dental care, and 95 percent of patients live below the federal poverty level.
An advisory group assembled to help out, but other health-care providers started preparing for the worst.
Consultants estimated that if the clinics were to close, it would send another 14,000 patient visits a year to Cottage Health System's Santa Barbara and Goleta hospital emergency rooms, so leaders had to develop a contingency plan, according to Cottage CEO Ron Werft.
“That’s like a 30 percent increase for us,” he noted.
Even with hiring more staff, there wouldn’t be enough space to handle that new load of patients.
If the clinics close, Santa Barbara Cottage Hospital would have to erect "surge tents" in the parking lots to handle the influx of emergency department patients.
“We have designed a new emergency department, but it doesn’t come online until 2018,” Werft said. “This emergency department that we’re operating in now was designed for 25,000 annual visits, and we’re treating 42,000 a year.”
Hospital staff train and rehearse with the surge tents twice a year in preparation for disasters, but the only time they’ve come close to using them has been when other medical facilities closed, Werft said.
“We put them in the parking lot to take care of the hundreds of patients that might present during a disaster — fire, train wreck, that sort of thing,” he said. “We were preparing as if this were a disaster. And I think it would have been.”
The clinics were in jeopardy of closure because they have a mission to treat all patients, regardless of ability to pay, but are seeing an increase in people who can’t pay for services. There’s also a decline in community giving, and the clinics were losing $250,000 a month earlier this year.
Neighborhood Clinics assembled an advisory group with Cottage Hospital, Sansum Clinic, the Santa Barbara County Public Health Department and CenCal Health, the Medi-Cal administrator for the Central Coast.
The advisers and consultants discovered that Neighborhood Clinics gets the lowest reimbursement rates of any local medical establishment, and needs to get better at managing costs, getting more private-insurance patients, expanding grants and garnering community support.
To add to those troubles, the Isla Vista Clinic is located in a former Redevelopment Agency-owned building that could be sold off if the state Department of Finance mandates it.
The county Board of Supervisors is fighting to keep it, since it’s the only public-health clinic in that community of 22,000 people.
A coalition of donors — including health-care organizations and foundations — put a 100-day turnaround plan into motion. In July, the groups put in $250,000 and promised another $350,000 if certain milestones were met.
Funders for this effort include the Santa Barbara Foundation, the Alice Tweed Tuohy Foundation, the Ann Jackson Family Foundation, Cottage Health System, the Mosher Foundation, the Hutton Parker Foundation, the Linked Foundation, the James S. Bower Foundation, the Sansum Clinic, the Outhwaite Foundation, the Saint Francis Foundation, the Wood-Claeyssens Foundation, The Fund for Santa Barbara and the Gildea Foundation, as well as individual donors.
In early October, the donors paid out the last payment of the $600,000 cash infusion to Neighborhood Clinics after deciding the organization had made significant progress in righting its fiscal ship.
The Neighborhood Clinics hired a new interim CEO, Trula Ann Breuninger, in July, and has reportedly restructured its board.
It also has been working to cut down on expenses over the past few months. Administrators moved out of the offices at 1900 State St. and into the second floor of the Eastside Clinic at 915 N. Milpas St., according to Neighborhood Clinics board president Mark Palmer.
The group's 2,990-square-foot offices are up for lease now and are posted at $5,920 monthly rent.
“When you’re losing money, you have to find ways to save money,” Palmer said.
Palmer wasn’t ready to discuss specifics of the 100-day period’s successes yet, but said the Neighborhood Clinics is still working with its donors to make plans going forward.
The organization is working on a process to increase the reimbursement rates now, since it just received its audited financial reports, Palmer said.
“This community is so awesome in how so many people came together to help us in so many different ways,” he said.
The clinics are too important an organization to close, serving the safety-net population of low-income, uninsured and homeless patients, said Tom Parker, president of the Hutton Parker Foundation.
“To live within their financial abilities, they need to both raise revenues from patients and community donations – they cannot operate in the red and they know that,” Parker said. “I think they’ve actually stepped up.”