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Q&A with Ed Martinez

San Ysidro Health Center stays fiscally fit

How is SYHC doing in the current economy and state of health care reform?

SYHC continues to maintain a stable financial base within a regional, recessionary environment characterized by high unemployment and loss of health insurance coverage; an increasing number of home foreclosures, and minimal economic growth/development in many areas of the regional economy.

In terms of health care reform, SYHC has been very successful in gearing-up for expanded health coverage authorized by health care reform legislation approved in 2010. To expand service capacity, SYHC received approximately $12.1 million in 2010 to construct a new primary clinic in southeastern San Diego, and remodel an existing medical clinic in San Ysidro. SYHC also received $1.3 million to expand our medical work force in anticipation of new patient activity funded by the federal expansion of health insurance coverage.

How is SYHC preparing for the uninsured who will become eligible for care under new health care reform, and how will those changes affect SYHC?

New federal grants have allowed SYHC to initiate new expansion efforts in the areas of work force capacity and program facilities. The previously mentioned (new) primary care clinic in southeastern San Diego will allow us to expand SYHC's program space from 8,000 square feet to approximately 26,000 square feet -- a little more than a threefold increase in program space for patient service activities. The remodeling program at our San Ysidro clinic will make it possible to expand both clinical and health promotion services. SYHC’s work force will expand by approximately 40 FTE (full time equivalent) physicians, dentists and support personnel in order to implement our anticipated service expansion initiatives.

Ed Martinez

These service enhancements/changes will all have a positive impact on SYHC by expanding our service capacity. SYHC anticipates that these service expansion initiatives will increase patient care activity by approximately 15,000 to 20,000 patient visits in FY 2012-2013.

What does SYHC need to further provide health care services for underserved areas?

The new federal grants will make it possible for SYHC to respond to the anticipated service expansion created by the new health reform legislation. However, with an existing patient population of 73,000 registered patients, and a service area encompassing the South and Central Regions of San Diego County, our greatest concern at this time relates to the potential funding cutbacks proposed by Gov. Brown in his FY 2011-2012 state budget. The governor's budget proposes to cut Medi-Cal by $1.7 billion -- a devastating reduction of essential health services for millions of low-income, underserved Californians.

The economic viability or our county's health care safety net is seriously threatened by these budget proposals. SYHC and all the other community clinics in San Diego are now gearing up to oppose these proposals by partnering with statewide advocacy organizations, and informing our elected officials of the budget threats to ongoing patient services.

How will SYHC continue to meet the needs of a growing, diverse population?

SYHC’s response to difficult economic times has always been to emphasize the importance of delivering high-quality health services in a cost-efficient manner. Our experience has demonstrated that the key to continuing economic viability has been to provide quality services in a dignified and respectful manner. This service delivery approach is the key to effectively addressing the unmet health needs of underserved communities.

How is the construction process going on the Euclid Family Health Center?

The city building permitting process is taking much longer than anticipated; however, I am pleased to note that we expect to receive our permit in March. Construction is anticipated to take approximately 12 months to complete. Occupancy will take place in the first quarter of 2012.

Our new Euclid Family Health Center will represent a significant new resource for the community of southeastern San Diego. The new 25,000-square-foot building will offer medical, behavioral, dental, nutritional and health education services. The care model will highlight family-oriented, primary care services. This approach incorporates a primary care provider (e.g., physician, dentist, or mental health provider) that will provide ongoing clinical services, care coordination and health promotion services. This holistic approach to health care will emphasize the importance of disease prevention measures and healthy lifestyles.

What are the big challenges for SYHC in the coming years?

Clearly, the major challenges facing community clinics in the coming years relate to the continuation of health services currently funded by the Medi-Cal program. Given the recession’s impact on the state economy, community clinics are very concerned about threatened funding cutbacks to safety net health programs. The situation is truly conflicted -- at the federal level, Congress has passed health care reform legislation that will expand health insurance coverage to approximately 200,000 residents in San Diego County; at the same time, the state is proposing to implement severe cutbacks in safety net funding. These cutbacks will have the most negative impact on our most vulnerable patients -- underserved women, infants and the frail elderly.

What accomplishments in the last year are you especially proud of?

Looking back this past year, I am especially proud of the fact that our health center has continued to be guided by the legacy of our Founding Mothers -- a legacy that highlights the importance of addressing the unmet health care needs of our diverse community. In 2010, our employees were successful in accomplishing all of the following projects which focused on unmet community needs: developing a new medical clinic and remodeling an existing comprehensive care health center; opening a new Adult Day Health Center for frail seniors; opening a new school-based health center at Lincoln High School; opening a new behavioral health counseling center for children and adolescents; and expanding our Family Medicine and Pediatric Dentistry training programs in concert with UCSD and UCLA. FY2010 was a very busy and successful year for SYHC, and we all anticipate that FY 2011 will be just as busy and just as successful.

-- Compiled by Michael Chung Klam

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