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A working model for health care

Health care reform has moved to the back burner on the president's agenda. With all the backroom partisan finagling, voluminous reform content and congressional realignments that tilt votes in one direction to another, it's hard to say when and if the Health Care Reform Bill will pass.

For community clinics throughout the United States and in San Diego, concern continues about short and long-range funding of programs and services for low-income families. This is particularly accentuated with the increase in unemployment, under-employment and loss of insurance benefits in the United States, which has driven an increasing number of individuals and families to community clinics.

The potential hold on health care reform increases the challenges of community clinics to care for the many people in need arriving at their doors, according to Ed Martinez, CEO of San Ysidro Health Center (SYHC).

"In San Ysidro Health Center's 40 years of operation, the health center's service area has grown to include the South Bay and central regions of San Diego," Martinez said. "Our commitment has grown as well. From the 40 patients a day we saw at our three-room health center in the late '60s, we now see more than 5,000 per month, more than 60,000 patients in 2008, and the number was even greater in 2009."

Ed Martinez

"It's important to recognize," he said, "that a key component of the president's health care reform package was to support the mission of community clinics in serving low-income, under-served populations. This part of the plan received bipartisan acceptance and offered genuine hope that health services would receive federal funding to improve the health and well-being of traditionally underserved and culturally diverse people."

In 1969, San Ysidro had only one physician to serve the 7,000 largely Mexican-American population in San Ysidro, a primarily agricultural community. Through a collaborative effort with the UCSD School of Medicine, SYHC opened its doors in 1969. Three volunteer nurses and two physicians saw approximately 40 patients a day. At the time of its founding, SYHC was considered one of the nation's newest and perhaps most innovative health resources in community medicine, with local residents taking ownership of the project.

In 1973, San Ysidro Health Center opened a 7,000-square-foot health facility to medical, dental and optometric care with on-site pharmacy, laboratory and radiology departments, programs for pre-natal, nutritional and geriatric care. Behavioral and mental health counseling, HIV/AIDS services, and a social services department were established as well as liaisons with the local school district in educational and preventive programs.

Martinez, who joined SYHC in 1998, has worked closely with the SYHC board and members of the community to build a health center that provides the highest quality comprehensive services to an ever-increasing population.

"We saw a strong community need for dental health, maternal and child services, urgent care, HIV programs and educational services," said Martinez, "and through collaborative efforts with the government and the private sector, we've made great progress."

In 2008, SYHC collaborated with Rady Children's Hospital to assume the operation of its Pediatric Dental Clinic. This joint effort has enabled the SYHC-operated San Diego Children's Dental Center to provide comprehensive oral health services to low-income, uninsured children throughout San Diego County. The landmark collaboration with Rady Children's Hospital also includes a partnership with UCLA's School of Dentistry to train pediatric dentists as part of a long-term commitment to the health and well being of children in San Diego.

Also in 2008, San Ysidro Health Center acquired Comprehensive Health Centers, a network of three clinics in danger of financial collapse that would have put significant strain on San Diego's health care safety net. SYHC's strong management team positioned the organization to assume the operation of these clinics located in San Diego's southeastern and central communities. SYHC now provides an essential continuum of care for people in these underserved areas.

In 2009, SYHC opened a new Maternal Child Health Center (MCHC) on an approximately 2.5-acre site adjacent to the existing health center. The MCHC offers women and children a one-stop network for essential primary care services. Last year SYHC also received a $1.3 million grant from the American Recovery and Reinvestment Act (ARRA) to establish a new access point community clinic in National City. The new satellite facility, called Paradise Hills Family Clinic, now provides primary care services for underserved residents in and around National City.

The organization also received $1.1 million grant to help meet the need for health services in the South and Central regions of San Diego County. The program targets low-income populations, seasonal farm workers, people experiencing homelessness and/or residents of public housing, and the uninsured.

In late 2009 San Ysidro Health Center received $9.75 million from the nearly $600 million in American Recovery and Reinvestment Act to build a health center in the southeastern San Diego region.

"The funds will finance construction of the Euclid Family Health Center, a new 15,465-square-foot, comprehensive primary care facility that will increase access and improve efficiency by providing a 'one-stop-shop' model of care for the community," Martinez said.

"At San Ysidro Health Center, we believe our program is a strong model for the nation on how to deliver health services to a culturally diverse, underserved, low-income population."


Ellman is a founder and principal of Beck Ellman Heald.

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