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Eastside Neighborhood Clinic (September 24, 2012)

Paul Wellman

Eastside Neighborhood Clinic (September 24, 2012)


Neighborhood Clinics In Real Danger of Closing

System Provides Health Care to Low-Income Residents at Little to No Cost


Friday, May 24, 2013
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A debilitating combination of more patients, less revenue, and major changes in the country’s health-care landscape has put Santa Barbara Neighborhood Clinics (SBNC) on a very real chopping block. If the organization doesn’t raise $1.5 million in short order, all three of its medical clinics and its dental office could close by the end of July, SBNC officials said this week.

The system of clinics, established 40 years ago, provides health care to 17,000 patients, explained acting CEO Mark Palmer. Ninety-five percent of the patients are considered low-income or very low-income, and there were 56,000 clinician visits last year alone. If these patients no longer have access to the network, they could be forced into emergency rooms more often, which is a much more expensive alternative to care, said chief medical officer Charles Fenzi.

In a prepared statement, SBNC officials said the organization is not fully reimbursed for patient visits, so it depends on donations to fill the “mission gap.” Its current business model is simply no longer viable because donations have dipped at the same time operating expenses and costs of complying with regulations have increased. In the scramble to stay afloat, SBNC has reached out to Cottage Health System, Sansum Clinic, and the Santa Barbara County Public Health Department for guidance and funds. A consultant’s report on the situation is due in a few weeks, at which time SBNC’s Board of Directors will start making long-term decisions.

“We are asking the community to give what they can, and we are asking the foundations to renew their commitment to the health of Santa Barbara,” said Palmer in the statement. Donations can be made online at sbclinics.com, by phone at (805) 617-7869, or mailed to Santa Barbara Neighborhood Clinics, 1900 State St., Suite G, Santa Barbara, CA 93101.

Comments

Independent Discussion Guidelines

ObamaCare has promised to take care of this. Just wait it out.

foofighter (anonymous profile)
May 24, 2013 at 12:23 p.m. (Suggest removal)

But we got money to entertain tourists.

Ken_Volok (anonymous profile)
May 24, 2013 at 1:13 p.m. (Suggest removal)

Clinics take money to run. They don't make money. Tourism brings in money and we get to keep it. You need both: rather than seeing it as either/or.

foofighter (anonymous profile)
May 24, 2013 at 3:13 p.m. (Suggest removal)

Okay so where is the City's actual return on investment of the dollars it spends on something like Fiesta for example. Seems like clinics are in more dire need than an event that, if Santa Barbara is such the tourist haven then we don't really need Fiesta to promote SB. Let the businesses who profit most pay for it and we still get the taxes.
I'm sure the very civic minded Randy Rowse would step up to the collection plate. He definitely profits from Fiesta. Maybe he's also like people with tuberculosis and untreated infections working for him as well since they won't even have the clinics to fall back on.

Ken_Volok (anonymous profile)
May 24, 2013 at 3:24 p.m. (Suggest removal)

Retail sales tax, fees and licenses is what mainly funds city operations. Voter approved surtaxes like Measure B as well. Along with federal or state grants with massive strings attached that override city council autonomy about how that money gets used and what has to be paid back in return.

The more you can sell things downtown to more than just city residents during an event like Fiesta, the more money that comes in to city coffers.

This is why the degradation of downtown due to vagrants and intimidation of resident shoppers is so profound an issue that city councils should not be ignoring.

The clinics are valuable. Hopefully Cottage Hospital Foundation can see them through until ObamaCare settles out because they have the most direct interest covering this level of care the clinics have been able to generously provide for so long.

But for the rest of the city funding, it is best to use the word "and" rather than "or". We do both - Fiesta and indigent care. Not Fiesta or indigent care. Works better. Everything has limits. Lesson one.

Cannibalizing civic activities in favor of only one or the other is not healthy for anyone. We do both, as best we can. And we also know when we can't do any more of either.

foofighter (anonymous profile)
May 24, 2013 at 6:17 p.m. (Suggest removal)

Foo Fighter: Ken and I have been around the S.B. area a LONG time, and we see how the game works; the Chamber of Commerce/politicians tell us (and perhaps truly believe) that more tourism will positively affect our lives, but at the end of the day, for the vast majority, it just means more tourists/traffic.

Think about it, if you're the average person your day-to-day survival depends on the money you make from your job, not the money someone else makes from tourism. I'm not knocking tourism per se, but in and of itself tourism does not solve all our problems.

billclausen (anonymous profile)
May 24, 2013 at 6:20 p.m. (Suggest removal)

So what is your plan to increase city revenues.... or reduce city expenses.

We have a large number of devoted motel units in this town so one would expect X number of tourists and their cars coming to fill those TOT producing units. Do you recommend we close them down? And the restaurants that serve this part of town?

How many local residents even use this part of town often enough to be inconvenienced by tourists?

Yes, a few large events like Earth Day, Oak Park Festivals, Solstice and Fiesta draw larger groups of out of town tourists for a few days ...only. But they also draw larger numbers of local tourists to these same locations as well.

Do you also suggest because of these few days of traffic increase while people are enjoying these events that we stop these events as well?

I suspect you two don't know this community very well after all.

foofighter (anonymous profile)
May 24, 2013 at 9:37 p.m. (Suggest removal)

Locally owned businesses such as hotels keep the money in the community. With most of the hotels etc now we only get the meager sales tax and the money mostly leaves the community to:
(a) outside corporations
(b) outside banks (with no local offices)
(c) irrational rents force workers to live elsewhere so grocery and other expenditures are spent in Ventura and elsewhere.

Obviously the key is supporting our local businesses before all others. My first idea to raise revenue is to put a tax on the income of all corporations/businesses who are not headquartered in Santa Barbara, Ventura, or San Luis Obispo Counties.

Ken_Volok (anonymous profile)
May 24, 2013 at 9:46 p.m. (Suggest removal)

Foofighter: Property tax generates around 20 times the income of TOT. The city has an incentive to restrict the supply of housing to maintain real estate value, and little incentive to fill State St. commercial RE vacancies. I read this recently on City-Data.
"There is a very large homeless population there, especially mentally ill homeless, because in the entire county there are only 16 psychiatry hospital beds. You will see them all over, and many are not shy. State Street is full of them, plus it is packed with tourists from Europe and Asia. This bothers those who live there."
http://www.city-data.com/forum/califo...

14noscams (anonymous profile)
May 24, 2013 at 11:27 p.m. (Suggest removal)

Looks like Santa Barbara's secrets are all over the internet.

Ken_Volok (anonymous profile)
May 25, 2013 at 12:27 a.m. (Suggest removal)

Time to re-open state institutional care facilities and money and effort wisely spent, instead of the current ineffectual, counter-productive and destructive Homeless Inc. status quo.

How much does the city get from property taxes? My ignorance. I thought this went to the county and state.

Actively depressing property taxes by converting 17% of housing units to low-income, fixed price housing and using high value downtown land for indigent public housing has taken a large part of potential property taxes now permanently off the books.

Has this long-term loss ever been monetized, along with the loss of buying power that comes with this high concentration of low-income people surrounding the downtown retail core?

Did anyone run the numbers of this long-term and permanent impact on the city's fiscal health when this massive confiscation of land now dedicated permanently for low-income uses was taking place? One gets the impression prior city councils spent like money would continue to grow, but acted in ways to ensure it would not.

foofighter (anonymous profile)
May 25, 2013 at 8:33 a.m. (Suggest removal)

Volok, what steps are necessary to tax corporate income not headquartered locally.

Seriously, how would you accomplish this because just tossing out wish lists is not a plan. Since the city has real problems, one needs real solutions not ideologue fantasies.

Have you discussed your corporate taxation plan with Capps, Williams or Jackson? Who carries the water for you to get this done.

Schiender had a plan - raise city income taxes and that went no where. How will you pull off your plan, and what is your Plan B if you cannot accomplish this corporate taxation in the immediate future.

foofighter (anonymous profile)
May 25, 2013 at 8:40 a.m. (Suggest removal)

"Tossing out wish lists is not a plan"
Wow you really are just a partisan hack after all aren't you
, and that's putting it nicely.

Ken_Volok (anonymous profile)
May 25, 2013 at 11:45 a.m. (Suggest removal)

"Time to re-open state institutional care facilities and money and effort wisely spent, instead of the current ineffectual, counter-productive and destructive Homeless Inc. status quo."
-- foofighter

Amen, brother. Amen.

SezMe (anonymous profile)
May 27, 2013 at 1:43 a.m. (Suggest removal)

Even a broken clock is correct twice a day.

Ken_Volok (anonymous profile)
May 27, 2013 at 1:45 a.m. (Suggest removal)

Posted on May 25 at 8:33 a.m.

"Time to re-open state institutional care facilities and money and effort wisely spent, instead of the current ineffectual, counter-productive and destructive Homeless Inc. status quo." -Foofighter-

I agree. It's easy to blame Reagan for dumping the mentally ill out on to the streets but why do those who have succeeded him in the many years that have followed get a free pass for not fixing the situation?

billclausen (anonymous profile)
May 27, 2013 at 3:30 a.m. (Suggest removal)

Eat the Rich..

Byrd (anonymous profile)
May 27, 2013 at 7:22 a.m. (Suggest removal)

No one can be denied life, liberty or property without due process of law. In California, the Lanterman-Petris-Short Act was passed in 1967. The sections on involuntary holds can be found in Welfare and Institutions code, sections 5150 and 5170. To read more, put 5150 in your search engine.

You can't lock granny up in a nursing home even if she has dementia without taking her to court and having her declared a "danger to herself or others."

My neighbors tried locking up their very annoying father after he was hospitalized and released. They transported him to a senior facility and he called a cab and went home.The oldest son sent neighbors an e-mail asking that no one help him so they could lock him up safely. The neighbors arranged meals on wheels and car trips to the grocery store. Is he a pain in the neck? Yup, but he is not a criminal, just annoying.

Most of the folks who go to the SB Clinics are not mentally ill or old (5%). Most are poor Hispanics (66%) who have no health insurance because they are not eligible for Medi-Cal. Medi-Cal and Medicare do not cover dental care. Stats are on the clinic website.

If the clinics close, Santa Barbara County will have to take care of them, out patient. Counties must provide health care to all comers whether they are in the country legally or not. The same goes for hospital emergency rooms. If the clinics close, the costs will simply shift to other health providers.

LHThom (anonymous profile)
May 27, 2013 at 11:53 a.m. (Suggest removal)

But don't you think it's more important to spend 1.5 million on a Fietsa?

Maybe there should be an Occupy Fiesta if the clinics close.

Ken_Volok (anonymous profile)
May 27, 2013 at 11:57 a.m. (Suggest removal)

How about an "Occupy bulbouts" instead?

Botany (anonymous profile)
May 27, 2013 at 12:06 p.m. (Suggest removal)

You can and should if it really means that much to you; but people will think your priorities are as screwed up as the Montecito Association's.
But I'd bring you a lemonade just to say "hello".

Ken_Volok (anonymous profile)
May 27, 2013 at 12:17 p.m. (Suggest removal)

What a non-productive conversation! If one started about three comments in, they would have no idea that the SBNC system is in danger of going out of business. This is NOT even a City Government issue, it is a County Public Health Issue. SBNC plays a critical role in SB County's public health safety net, along with American Indian Health & Sevices and the County of SB Health Care Services. If SBNC goes out of business, the 2 remaining entities will be left to absorb the 17,000 patients and 56,000 visits referred to in this article. This is not feasible, as they are already stretched to the max. Cottage Hospital is the single private entity that has the most to lose in this crisis, as they will be the ones "eating" the ER uncompensated care, but the community as a whole will suffer as well. This private-sector issue can turn into a County Public health emergency, and a behemoth like Cottage has the resources to help to mitigate this problem, until, like "foofighter" suggests, Obamacare kicks in, but that is not until January. Cottage's BOD might see fit to part with some tiny percentage of that gazillion-dollar endowment of theirs and help the community get through this. If they could raise enough money to build the state-of-the -art facility that they currently have, they can come up with the $1.5M from "petty cash". The bigger question going forward is, what then?

I have worked within the local public health system in the past. I have firsthand knowledge what they are up against. I also know that this did not happen "over night", and question why we are just hearing about this now, allegedly 2 months before "Armageddon", when there are systems in place that can and should be able to forecast more than two months at a time. Not time to point fingers, but in order to save a necessary local asset, there needs to be proactive management in place to do so. This is a combination of a "perfect storm" of unfortunate events - the increasing number of uninsured patients since the economy tanked in '08 and, while unemployment may be decreasing, employers who provide healthcare are not., often "gaming" the system to hire more part-time workers to avoid having to provide health benefits, which forces these folks into the "system" to get health care. There is no where to go except for these local clinics.

The other interested party which IS governmental is the County of SB, who has the unfunded legal responsibility to care for these folks as the "provider of last resort". What this means to everyone now getting care at the County Health Care System, you will get less care with longer waits, which always costs more in the long run.

This is a major public health issue that should be addressed immediately by the entities with the means to do so. If there are private donors with the means, they should step up as well for the good of the community.

Those of you debating "vagrants" and "tourists" are off the mark.

Gandalf47 (anonymous profile)
May 27, 2013 at 5:30 p.m. (Suggest removal)

One other comment - Read The Angry Poodle for a stark contrast to this story. Disgusting!

Gandalf47 (anonymous profile)
May 27, 2013 at 5:32 p.m. (Suggest removal)

Gandalf obviously was too upset to read the entirety of people's comments and how they related to the story. Yet you addendum with " Read The Angry Poodle for a stark contrast to this story.".., ha!

Ken_Volok (anonymous profile)
May 27, 2013 at 7:03 p.m. (Suggest removal)

Ken_Volek - You are a negative blowhard, and what does your last post even mean? Of the first 22 comments, 15 of them were from you and others going off about City politics and your pet peeves about taxes, vagrants, "Eating the Rich", the Montecito Association", "Occupy bulbouts", Fiesta, Randy Rouse, etc.. "foofighter" was trying to make some valid counterpoints, which eventually led him/her off the subject, too, and LH Thom actually attempted to get on point, too. I DID read the entirety of ALL the comments (not just yours, though you probably would rather it be so), and a large percentage of the discussion up until my first post was NOT specifically about the issue discussed in the article, and, more importantly, what we, as a community can or should do about it. I was just trying to draw the discussion back to the severe crisis that this community may face in a couple of months and what could be done in the short term. What's wrong with that? (I'm sure I will regret THAT question).

WRT to the contrast between a bunch of rich insurance fat cats wasting tens or hundreds of thousands of dollars "rewarding" themselves for huge profits with a "down low" celebration at the Sunken Gardens and Bacara Resort - I don't get what your "ha!" means. Is it that you support their huge profits and tone deaf celebration while local public health clinics go bankrupt .... or what, were you agreeing with me? I can't tell.

I guess if the discussion isn't about the City Council or some other local issues that personally excite your "sensibilities", it doesn't matter, right? Just because you have nothing better to do than post comments to the Indie all the day, every day, that doesn't mean that there are not REAL issues and REAL discussions to be had by those of us who care more about the community as a whole than you do about your "pet" issues. Just because you have lived here a long time doesn't give you a monopoly on the truth - a lot of us have lived here a long time. I've read your comments on other issues before, and you tend to be long on snarky opinions and short on facts. You never even addressed the substance of my first comment - you just attacked me, in "typical Ken V" fashion.

What kind of health insurance do you have Ken? Is it threatened by the possible closure of the SBNC? Do you even care, or is that not even on your radar? I'm just asking, since your comments don't seem to reflect a point of view either way - just attacks on this or that - anything but the topic at hand. "foofighter" was bending over backwards to try to engage you in a substantive discussion, to no avail, except for you to label him/her a "partisan hack". Ken - it takes one to know one.

Gandalf47 (anonymous profile)
May 27, 2013 at 8:13 p.m. (Suggest removal)

I'm sorry gandalf, I couldn't help but poke a hole in your pompous balloon.

Ken_Volok (anonymous profile)
May 27, 2013 at 8:25 p.m. (Suggest removal)

Plenty of the people living on the streets are a danger to themselves and others, but firstly to themselves. It is insane to let people live on the streets of any town. They belong in care facilities like the state used to provide. Yes, due process is critical to prevent any possible abuse.

Tthe choice to live in the dangers of the street today, particularly with the violence inducing drugs that are part of the street culture, is prima facie evidence for state protection which comes merely from the decision to live on the streets themselves.

Too many people feel threatened to come down town any longer - so many of these people are threats to other too. Show a little compassion folks, get these people off the streets and into institutions dedicated to provide care and protection. Das Williams and Hannah-Beth Jackson should be making this their top priority if they really care about the environment and the creatures of this earth -- people too need protection from themselves and others.

These people are not romantic road warriors; they are helpless and vulnerable when left on the streets and they cannot be mainstreamed into normal housing either. Be realistic and re-open state institutions. Nothing has replaced their care level for thousands of those now permanently living on the dangerous streets.

foofighter (anonymous profile)
May 27, 2013 at 8:33 p.m. (Suggest removal)

Nobodygoes downtown anymore because there's not much there but bars, not because there are homeless people there (who do indeed need varying degrees of assistance.) But I think we might be venturing into controversial territory again, and we wouldn't want to piss the wizard off.

Ken_Volok (anonymous profile)
May 27, 2013 at 8:42 p.m. (Suggest removal)

Gandalf is right, Foofighter makes good points, and KV is, as usual, a troll devoid of any constructive ideas. We need universal healthcare coverage ASAP.

blackpoodles (anonymous profile)
May 27, 2013 at 9:36 p.m. (Suggest removal)

Got your goat, did I, Kenny? It's all about ME, now?

Gandalf47 (anonymous profile)
May 27, 2013 at 9:36 p.m. (Suggest removal)

I've not only argued for Universal Health Care, I've fought for it. And I'm glad trashy people hate me.

Ken_Volok (anonymous profile)
May 27, 2013 at 9:41 p.m. (Suggest removal)

It takes one to know one, KV. Glad to hear you are fighting for Universal Health Care, though.

blackpoodles (anonymous profile)
May 27, 2013 at 9:48 p.m. (Suggest removal)

It was just a lucky guess.

Ken_Volok (anonymous profile)
May 27, 2013 at 9:57 p.m. (Suggest removal)

1) make these poor people sell their expensive cars
2) Sell their jewelry
3) Drug test them for eligibility
4) Make them pay at least $30 per visit
5) Require them to do community service if they aren't working

In other words, they need to stop milking the system and start carrying their own weight for a change......

retprotector (anonymous profile)
May 28, 2013 at 7:58 a.m. (Suggest removal)

Does a program encourage dependency upon government services? Or does it facilitate getting off dependency on government services?

retroprotector, you make very good points. No government service should come without some form of required reimbursement, either in services or payment. This dignifies the service, the recipient and the provider.

foofighter (anonymous profile)
May 28, 2013 at 8:21 a.m. (Suggest removal)

how is obamacare going to help this?

redbunz (anonymous profile)
May 28, 2013 at 9:22 a.m. (Suggest removal)

Compassion fatigue is setting in...

garfish (anonymous profile)
May 28, 2013 at 10:25 a.m. (Suggest removal)

You cannot lock someone in an institution unless you can prove the following:

5150 criteria

The criteria for writing requires probable cause. These include danger to self; danger to others together with some indication, prior to the administering of the hold, of symptoms of a mental disorder; and/or grave disability, as noted below. The conditions must exist within the context of a mental illness.
1.Danger to self: The person must be an immediate threat to themselves, usually by being suicidal. Someone who is severely depressed and wishes to die would fall under this category (though they generally have to have expressed a plan to commit suicide and not just a wish to die).
2.Danger to others: The person must be an immediate threat to someone else's safety.
3.Gravely disabled:
1.Adult (patients over 18 years of age): The person's mental condition prevents him/her from being able to provide for food, clothing, and/or shelter, and there is no indication that anyone is willing or able to assist him/her in procuring these needs. This does not necessarily mean homeless, as a homeless person who is able to seek housing (even in a temporary shelter) when weather demands it would not fall under this category. Also, the mere lack of resources to provide food, clothing, or shelter is not dispositive; the inability must be caused by the psychiatric condition.
2.Minor (patients under 18 years of age): The person is unable to provide for his/her food, clothing, and/or shelter or to make appropriate use of them even if these are supplied directly—for example, a psychotic adolescent who refuses to eat because he/she believes his/her parents are poisoning them.

The state budget is in the red. There is no money to build state institutions and even if there were money, the homeless who are drug and alcohol dependent do not want to go to institutions.

Last, the SB Clinics are not serving mentally ill people. They are serving poor people who are mostly Hispanic, 2/3's of them. If there is not money for basic medical care for poor people, where is the money going to come from to build institutions to put homeless people in who do not want to be there?

LHThom (anonymous profile)
May 28, 2013 at 10:53 a.m. (Suggest removal)

Some some real sickos here and they wonder why they consistently lose elections.

Ken_Volok (anonymous profile)
May 28, 2013 at 11:28 a.m. (Suggest removal)

"....3) Drug test them for eligibility..."
-- retprotector

Sure I'll go along with that - under one condition, namely, that everyone on public salary undergo the same testing and consequences. Throw in every CEO of every company that has a contract with government and you have a winner.

SezMe (anonymous profile)
May 28, 2013 at 10:34 p.m. (Suggest removal)

"Sell their jewelery"
-- retprotector

Including wedding bands? Now who's redefining marriage?

Ken_Volok (anonymous profile)
May 28, 2013 at 10:50 p.m. (Suggest removal)

What is your opinion on a public option spiritwalker?

Ken_Volok (anonymous profile)
May 29, 2013 at 2:37 a.m. (Suggest removal)

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