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<b>TICKING CLOCK:</b> Trula Ann Breuninger turned around two failing community clinics before, and the hope is that she can work her magic again with the fi nancially troubled Santa Barbara Neighborhood Clinics. Breuninger doesn’t have much time; she was hired as interim CEO for the next 90 days.

Paul Wellman

TICKING CLOCK: Trula Ann Breuninger turned around two failing community clinics before, and the hope is that she can work her magic again with the fi nancially troubled Santa Barbara Neighborhood Clinics. Breuninger doesn’t have much time; she was hired as interim CEO for the next 90 days.


Health Clinics Secure Donations, Hire Temp CEO

Major Foundations Give $600,000 To Keep Program Afloat


Thursday, July 18, 2013
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Santa Barbara’s financially beleaguered Neighborhood Clinics managed to secure $600,000 in funding from a coalition of some of Santa Barbara’s biggest foundations to stay afloat for at least another 100 days, during which time the organization’s board of directors hope to hammer out a plan for its long-term survival. Key to that was the selection of a new ​— ​if interim ​— ​chief executive officer, Trula Ann Breuninger, a community health-care consultant out of Santa Monica.

Breuninger, a Navajo by birth, has extensive experience running Native American community health clinics and has reportedly turned two around before they went down the drain of fiscal ruin. Commenting on the hole the Neighborhood Clinics are in, Breuninger said the problems are “manageable.” She noted, for example, that the clinics suffer from a high number of patients who fail to show up for their appointments. That needs to be addressed, she said, if they are to meet the large ​— ​and growing ​— ​population of underserved low-income patients who rely on them for basic medical care.

Currently, the clinics serve 17,000 patients a year providing 51,000 office visits. Almost none have insurance, placing a major drain on the clinics. (Should the organization go out of business, however, it’s expected that a significant number of its clients would be forced to seek care at the emergency rooms operated by Cottage Hospital. Not only would that prove more costly in the long run, it would gum up emergency rooms already experiencing congestion problems. In part, because of this, many of Santa Barbara’s leading philanthropic organizations ​— ​not to mention Cottage Hospital ​— ​have contributed hundreds of thousands of dollars to keep the clinics afloat.) Likewise, the federal formula by which the clinics are reimbursed for services rendered is parsimonious in the extreme.

Those two facts have accounted for much ​— ​though not all ​— ​of the clinics’ financial woes. As the Affordable Health Care Act goes into effect next January, the number of eligible clients who can actually pay for services will increase dramatically; when that happens, something as mundane as efficient scheduling will prove essential. In the meantime, Breuninger will take steps enabling the clinics to apply for higher re-reimbursement rates. One way, she said, would be to add mental health to the menu of services offered. Toward the same end, movers and shakers with the clinics have been aggressively exploring a possible merger with American Indian Health & Services, another nonprofit serving a similar population.

For a host of bureaucratic and stubborn reasons, American Indian Health enjoys a higher rate of return on the same services than do the Neighborhood Clinics. In that light, Breuninger’s experience in Native American health-care management makes her a strong choice. While Neighborhood Clinics board president Mark Palmer acknowledged a keen interest in such a merger, he stressed that Breuninger was selected strictly because she was the most talented candidate. In the meantime, Breuninger said she has her work cut out for her. “Where there’s unrest in any organization, you have to restore the trust of the staff while getting people to move and to focus,” she said. “And you have to strengthen partnerships in the community.”

Comments

Independent Discussion Guidelines

Just out of curiosity, Nick, exactly what ARE the "host of bureaucratic and stubborn reasons" (an interesting descriptive phrase)?

There are many statements which have been made about this situation since the news broke a month or so ago about the dire nature of the SBNC which are "sort of true", but not exactly true.

There are many variables that go into calculating health care reimbursement (particularly for the poor and uninsured) at a public health level, and there are multiple manners in which reimbursement is paid, based upon the type of clinic that is operating, and, more importantly, the type of patients that it is predominantly being treated. I would like a little more specificity in exactly what those factors are, so that the public can better understand what really happened to the SBNC. If she doesn't already, I am sure that Ms. Breuninger would benefit from knowing that, too.

I have asked twice before on the Indie site for the name of the consultant who was engaged by Cottage to study the SBNC problem. Was the report delivered? To whom? What did it say? How much did it cost? Is it available for public review and/or input? If not, why not?

I'm just an interested citizen who wants the SBNC to survive, as the existing system cannot "pick up the slack" left by the vacuum in patient care delivery that will exist if the SBNC "goes under".

We have gone from "We are almost broke, and we're going to have to close the doors at the end of July" a couple of months ago, to "Cottage has hired a consultant to study this", to the CEO resigning and the Board Chair taking over CEO duties temporarily. Then, less than two months before the public even knew there was a problem they have HIRED an interim CEO! When was the recruitment process? How was in conducted? How was this person selected (AIH&S is the designated Indian clinic in SB, and is reimbursed accordingly, along with numerous IHS grants) so her Native American background won't necessarily apply with the SBNC). How could ANYBODY turn around a sinking ship in 100 days, especially coming in cold? Has ANYONE asked ANY of these questions before now?

Gandalf47 (anonymous profile)
July 18, 2013 at 11:18 p.m. (Suggest removal)

If these low-cost health care services are so essential to this community, why do so many patients not even show up for their appointments, which was identified here as one of the biggest holes in their operating budgets.

Why is city council candidate and former clinics director David Landecker bragging he left these clinics in "sustainable financial condition" when they are fiscally collapsing right under our noses today? What went wrong.

foofighter (anonymous profile)
July 21, 2013 at 10:51 a.m. (Suggest removal)

Since Landecker left his position in 2006 at the Neighborhood Clinics, your query Foo is just another pathetic attempt to smear an opposition candidate, based on nothing. So time for your full disclosure Foo, need help?

Ken_Volok (anonymous profile)
July 21, 2013 at 1:05 p.m. (Suggest removal)

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