Dr. Mahdi Ashrafian (left) and Dr. Charles Fenzi | Credit: Courtesy; Paul Wellman (file)
Maybe Dr. Charles Fenzi can finally get to take that vacation he’s put off for the past 10 years. Last week, Santa Barbara Neighborhood Clinics (SBNC) announced it had selected Fenzi’s successor as CEO of the safety-net health-care organization.
“We like this guy a lot,” Fenzi said of his replacement, Dr. Mahdi Ashrafian, who since 2016 has served as CFO for the Community Health Systems, which runs six safety-net clinics throughout Riverside, San Bernardino, and San Diego counties. Fenzi noted that Ashrafian, who will take the helm sometime this August, was selected out of a field of 50 interested applicants who inquired about the post after Fenzi announced his retirement in January.
Back in 2012, the then financially beleaguered SBNC was on precariously thin ice, and Fenzi, who had experience as a high-profile community health provider in Roswell, New Mexico, was tapped to stabilize the organization. Under Fenzi’s tenure — both an executive and practicing physician — SBNC not only was stabilized but also greatly expanded its services and increased the number of its patients from 17,000 to around 22,000 today.
The clinics Ashrafian comes from have slightly more patients than SBNC — 31,000 — but they serve the same underserved demographic. Most of the patients are low-income, working class, and Latino. Housing-navigation services are provided for those experiencing homelessness. Without Medi-Cal, many would have no insurance.
“We are part of the safety net,” Ashrafian said.
About 15 percent — mostly those without legal documentation — pay out of pocket. In Ashrafian’s clinics to the south, the sliding-scale fee is $35. At SBNC, it’s $45. And that’s for a visit that costs SBNC $150 to provide. With revenue gaps like that, Fenzi noted, SBNC has always had to rely on Santa Barbara’s philanthropic community. Whoever took over, he added, needed to be comfortable at doing the philanthropic dance. Ashrafian, he said, fit the bill.
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Fenzi expressed great enthusiasm for Ashrafian’s administrative chops. Both clinics rely on specialized federal funding streams reserved only for health-care providers serving safety-net populations. The network of clinics where Ashrafian worked provides a wide range of specialized care, including mental health, prenatal, pediatric, optical, preventative, chiropractic, and dental.
Ashrafian was born in Iran and lived there until he graduated from high school, at which point he moved to Indianapolis to be with his immediate family. The cultural shock was not as jarring as one might expect; he spoke English. It was more the bitter cold of Indiana’s winters that got to him. When the opportunity came to study medicine at UCLA, Ashrafian wasted little time taking it. California, it turns out, suited him. He always gravitated toward the practice of safety-net health care, he said.
Ashrafian said that he and his wife have always wanted to move to Santa Barbara since first visiting in 2016. “It still has a small-town feel,” he said. “It still has a sense of community.” Ashrafian and his family already put in a couple of offers on homes here only to come up short against all-cash offers for considerably more. “It’s tough,” he said of the city’s notoriously daunting housing market.
But almost as tough, warned Fenzi, are the challenges SBNC now faces in recruiting and keeping staff. Ever since UCLA started setting up clinics in Santa Barbara two years ago, Fenzi said, the competition for medical staff has grown intense. Almost immediately after, Cottage Health launched what would become a string of new urgent care clinics.
“UCLA really changed the environment,” Fenzi said. “They just bought another building at the corner of Chapala and Victoria — the one where the Police Activities League meets,” he said. “I don’t think UCLA is interested in our demographics per se; it’s our staff.”
That’s expressed in dollars and cents. And when it comes to the dollars and cents, he added, SBNC can’t compete toe-to-toe.
Ashrafian had nothing but praise for Fenzi. “He’s done a great job creating a solid foundation for this clinic,” he said. “I’m only one person, but with the board and with the staff and with the clinics’ leadership team, I’m hoping we can take it to the next level and expand our services.”