A primary clinic in Bankers Hill will be part of new effort to advance care 

By María José Durán

Judith left the American Indian Health Center on First Avenue dragging her walking boot all the way to the bus stop across the street. The community clinic has ordered her a brace to help the arthritis in her ankle, and to avoid surgery.

“It hardly hurts,” said Judith, who didn’t want to reveal her last name.

This 55-year-old has been attending the American Indian Health Center for almost 14 years. Her insurance covers most of her treatments. Of the ones that aren’t included, like dental, they give her a discount.

“I’m going to have a nice porcelain tooth and I paid it right with my credit card, $611,” Judith said.

In 2014, 441,754 people in Southern California were underinsured or didn’t have any insurance, according to a count of the Health Center Partners (HCP), formerly known as the Council of Community Clinics. Most of them are from low-income families eligible for Medi-Cal, but most doctors won’t take their insurance.

The uninsured make up 31 percent of all HCP patients. Undocumented immigrants who don’t qualify for insurance are part of this group. Their only chance when it comes to primary care is attending these health centers, because they can’t pay a private doctor’s bill.

Twelve community clinics have formed Integrated Health Partners (IHP), a consortium to advance the standards and reduce the costs of care at primary health centers. They represent more than 70 practice sites, including one in Bankers Hill just north of Downtown.

The American Indian Health Clinic in Bankers Hill will be part of IHP. The network of health centers provides primary care for low-income, uninsured or underinsured patients. Almost 500,000 Southern Californians will benefit from this association.

Only one in five community health centers will be participating in the new union. For example, Family Health Centers of San Diego has two clinics in North Park and one in Hillcrest. Its director of community and government relations, Timothy Fraser, could not say why they didn’t participate in the unity effort with other health centers. Fraser said that the decision was made above his level.

A fifth Community Health Center in Uptown, La Maestra in City Heights, is a member of the HCP, but not of its subsidiary new consortium IHP.

The Community Health Centers face new challenges with the expansion of Medi-Cal. Sabra Matovsky, executive director of Integrated Health Partners, describes how in the past few years, new patients with entirely different needs walk into their clinics.

“Medi-Cal has traditionally been mothers and children, but now the disabled, the seriously mentally ill, adults with chronic conditions have all come into Medi-Cal,” Matovsky said. “Combine a much more complicated patient with changes in the healthcare horizon where health centers need to start demonstrating the value of all this new insurance that people have.”

To tackle these issues, IHP plans to make all its partners work and take responsibility together.

“They have always collaborated but now they have come together to form one agency, now they will be all under one umbrella and all of them will be responsible collectively for the patients that they serve,” Matovski said.

The sponsor of Integrated Health Partners is a bigger organization, the HCP. Up to 17 Community Health Centers are members of this network that expands throughout San Diego, Imperial and Riverside counties.

The HCP serves 768,000 people. They offer discounts for uninsured patients. A visit with a Primary Care Physician costs $25 to $50, depending on income.

“Each one has its own unique niche in their community and the ethnic populations and the communities where they are located, but the quality across them is driven to be consistent,” Matovsky said.

Health center employees often speak Spanish and offer attention focused on the ethnical differences of their communities, but services are limited to primary care, dental and sometimes mental health. Specialists are rare.

“The specialist piece really comes in with our partners, the insurance companies,” Matovsky said. “If we find a doctor at the specialist level that works well with our patients and is understanding of their cultural needs, then (the insurance companies) have been willing to go on a contract with that specialist to bring them in.”

Richard Chambers is president of Molina Health Care California, one of the insurance companies that works with health centers in their efforts to extend quality care to the low-income population.

“We’ve made quality grants to them with funding that we’ve gotten with the expansion of Medi-Cal,” Chambers said. “The clinics are using the money to fund things like the start of IHP and other quality programs to make sure that they get access to high quality services.”

—María José Durán is a freelance writer from San Diego. She can be reached at [email protected].