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.”