CEO/Chief Medical Officer Dr. Charles Fenzi administers vaccine to SBNC Dental Assistant Carmen Perez Lopez. | Credit: Isaac Hernandez Herrero

Neighborhood Clinics is not yet ready to vaccinate patients, Dr. Susan Lawson, the clinic’s associate medical director, wrote to the Independent on Friday. It is currently vaccinating health-care workers only and is limited in space, workers, and vaccine. “We ask for our patients to be patient as we work through this process and know that we will contact them when the vaccines are available for them,” Dr. Lawton said.

Throughout COVID, Santa Barbara Neighborhood Clinics (SBNC) has been safely meeting the healthcare needs of the 22,000 patients it serves in south Santa Barbara County. Since last March, it has done more than 9,400 tele-health visits and continues to do limited in-person visits. SBNC has eight clinics providing medical, dental, and behavioral health services, primarily to low-income patients.

It recently vaccinated 150 of its 185 staff members (an impressive percentage compared to many providers) and is set to vaccinate the 22,000 patients it serves each year once it receives vaccines. As the trusted medical home for its low-income patients, SBNC will play an integral role in educating its patients on the vaccine’s safety and efficacy. It is now preparing Q&As on the subject to disseminate through various mediums.

COO/CFO Nancy Tillie, Campaign Cabinet Chair Peter MacDougall, and Board Chair Melinda Stavely at 2019 event. | Credit: Gail Arnold

SBNC has quickly adapted the delivery of its healthcare services as COVID’s prevalence has risen and fallen and as state and federal directives and guidance have changed. After Governor Newsom issued the first stay-at-home order last March, SBNC initiated tele-health visits for patients not requiring in-person care. This transition was done a mere four days after the order, a remarkable feat for which COO/CFO Nancy Tillie lauds Associate Medical Director Dr. Susan Lawton and the management and administrative staff. Since then, SBNC has done an astounding 9,400 plus tele-health visits.

For patients requiring in-person care, strict protocols and scheduling were established. Chronic disease management and well-child visits occur early in the day, followed by non-COVID ill patients, and then at the end of the day, patients suspected of having COVID are tested outside (most in their vehicles), or in an isolated area inside. In May, as COVID rates leveled off, more in-person visits began, but with the Governor’s lock-down order in December, SBNC reverted back to a more limited number of in-person visits.

Following the community’s COVID-19 Testing Triage Protocol, SBNC has tested more than 640 patients. According to Tillie, SBNC removes barriers to patient care — medical, dental, and behavioral —  providing healthcare to patients right in their neighborhood. As the medical home for its patients, when the pandemic hit, SBNC stepped right up to provide COVID testing.  

With the challenges of COVID, demand for SBNC’s behavioral health services and its substance use disorder treatment has increased. For some patients, the challenges have been from isolation, for others, from having adult and child family members home in tight quarters, for yet others, it has been financial difficulties. 

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The Bridge Clinic, which treats substance use disorders, has seen an almost 60 percent increase in visits from pre-COVID times by patients receiving medically assisted treatment. Most behavioral health services are done through tele-health, while the Bridge Clinic does a mix of in-person and tele-health visits.

For dental services, SBNC has been following CDC, CA Department of Public Health, and OSHA  directives and guidance, which at various times have prohibited all services or limited services to urgent cases. Dental operatories have been separated by barriers, and vacuums and foggers are used to sanitize between visits. Tele-health visits are used for pediatric wellness checks and follow-up care.  

When Santa Barbara emerges from the pandemic, tele-health will remain at SBNC. Tillie points to many benefits, including the removal of the transportation barrier and the ability to see more patients without funding additional space. Tele-health also facilitates access to specialists. “What better way to have whole person care,” Tillie posits, “than having your primary care provider and your specialists all in the room with you?“

Tele-health has been well received by many patients, but for some there have been technology challenges because of older phones and computers coupled with the bandwidth required for video and spotty internet service in some areas.These issues, Tillie is confident, can be overcome.

When Santa Barbara comes out of the pandemic, CEO/Chief Medical Officer Dr. Charles Fenzi sees even more demand for SBNC’s services. The clinics will need to get patients up to date on non-COVID vaccinations, which he notes is important for the individual as well as the community. Fenzi notes that measles, for example, is far more contagious than COVID and is not a benign disease. 

SBNC will also be dealing with a multitude of other deferred healthcare needs. It will face not only an increase in demand for services from existing patients, but also from new patients. Fenzi anticipates an expansion in patient rolls as the financial effects of the pandemic drive more people to rely on SBNC for their healthcare needs.

Pre-COVID, SBNC launched a $20 million capital campaign and is close to reaching its goal. About a third of the funding is for a new Westside Clinic, about half for operating funds, and the remainder for capital improvements and equipment for current facilities. The current Westside Clinic is a converted 1928 home that long ago became too small for the demand for services there. The new state-of-the-art clinic will be three times the size and offer medical, dental, and behavioral health services. A hearing before the Architectural Board of Review on the new Westside Clinic is set for January 25, 2021. 

While SBNC has received increased funding from the Health Resources Services Administration for its COVID response work, various other grants, and a Payroll Protection Program loan, community support is essential for SBNC’s operation. Last fiscal year, community support comprised 23 percent of its income. Two-thirds of income came from patient services (largely Medi-Cal, which does not reimburse for the full cost of services; about 30 percent of patients have no insurance) and 11 percent from federal grants.

An initiative launched shortly before COVID hit, the Good Neighbors Program, seeks donors at the $1,000 level and above to act as ambassadors in introducing SBNC to those in their circles. According to Fenzi, some donors want to do more than provide financial support and with this program they are tasked with sharing SBNC’s story with others in the community. One of the Founding Ambassadors, Sybil Rosen, shared how the hope is to have 100 Neighbors who will continue on each year, providing a steady source of income for SBNC, which it vitally needs. SBNC is close to reaching 50 Neighbors, which will trigger a $50,000 donation from an anonymous source. The program recently hosted a Zoom presentation for members on the work at SBNC, and periodic presentations will go live for neighbors once the pandemic is over.

SBNC operates on a sliding fee scale for patients with and without insurance, and never turns away anyone for an inability to pay. For more info or to make a donation at any level, click here. 

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