Posts Tagged ‘Santa Barbara Neighborhood Clinics’

Positive changes from a successful crisis management

December 1, 2013  |  Article, News  | 

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Sansum-Cottage deal heads to FTC for review

November 29, 2013  |  Article, News  | 



Santa Barbara Cottage Hospital is part of Cottage Health System, which plans to merge with Sansum Clinic, a physician network. (Business Times file photo)


By Marlize van Romburgh  /   Friday, November 29th, 2013

The future of health care in South Santa Barbara County became considerably clearer in recent days, with the biggest merger in decades headed off for regulatory review and hiccups in the delivery of care through the state insurance exchange and to the poor largely resolved.

Cottage Health System and Sansum Clinic said their merger is proceeding on track for completion early next year and is under review at the Federal Trade Commission. Sansum, for its part, has smoothed out some contractual sticking points that could have blocked those buying policies on Covered California, the state’s insurance exchange, from accessing its services.

Meanwhile, Santa Barbara Neighborhood Clinics, which provides low-cost care to the poor and serves about 17,000 patients a year, said it plans to expand in Goleta, bouncing back after nearly running out of money earlier this year.

Here’s a closer look at each development.

Merger heads to regulators

The proposed merger between Sansum Clinic and Cottage Health System would combine two nonprofit health providers that each employ thousands of people and see tens of thousands of patients a year.
Cottage spokeswoman Maria Zate said the two groups are moving forward with due diligence, and that the proposed merger has been submitted to the Federal Trade Commission to scrutinize for any potential market concentration issues.

“Based on what we know today, we’re hopeful that an affiliation might be finalized in the early part of 2014,” Zate said in an email.

A spokesperson for the FTC said the agency could not comment. However, health-care consolidation rarely comes under scrutiny from federal regulators — of the hundreds of hospital mergers in the U.S. since 1987, the FTC has challenged only a handful — and the Affordable Care Act encourages partnerships between health groups as a way to achieve greater operational efficiency.

“These kinds of mergers and partnerships are happening all over the state,” Jan Emerson-Shea, a spokeswoman for the California Hospital Association, told the Business Times earlier this year when the Sansum-Cottage deal was announced. “They’re not uncommon and they’re very much driven by the Affordable Care Act. There are financial incentives and financial penalties — for hospitals and clinics and other providers — that call for them to work more closely together.”

Sansum listed on exchange

Sansum said on Nov. 22 that its 23 outpatient medical clinics will serve patients who buy Anthem Blue Cross coverage on the state’s online health insurance exchange. Sansum is one of the largest primary  care providers in Covered California’s District 12, which includes Santa Barbara, Ventura and San Luis Obispo counties.

Lack of access to Anthem Blue Cross coverage through the state exchange had created a stumbling block for thousands of eligible people in the region. Indeed, because it did not have agreements with the exchange’s two providers, Anthem Blue Cross or Blue Shield of California, Sansum Clinic was not listed as a member of the network. “It’s a big breakthrough for the community,” Sansum CEO Dr. Kurt Ransohoff told The Business Times in a phone interview. “I have heard from many of my patients that they needed to get new insurance.”

Sansum said in a statement that by early December the Anthem Blue Cross website should list Sansum Clinic as a member of the exchange but said it was not clear when Sansum would be added to the Covered California website.

Ransohoff said Sansum was taking a decrease in its rates in order to join the network, but he also agreed that by being part of the exchange Sansum will be able to attract patients who are able to afford insurance coverage for the first time.

Sansum has not reached an agreement with Blue Shield of California, the other provider of insurance via Covered California. However, it has reach an accord with the University of California to be a Tier 1 provider on its UC Care preferred provider program.

“We’re thrilled to be the only insurer to have Sansum Clinic in our exchange network,” Ernie Schwefler, regional vice president of provider contracting at Anthem Blue Cross said in the statement.

Neighborhood Clinics

In a separate development, the struggling Santa Barbara Neighborhood Clinics nonprofit said Nov. 21 that it is narrowing its funding gap and has a strategic plan and new permanent CEO in place, putting it on track to become financially sustainable at a time when it looks to expand service to Goleta.

“Six months ago, we were in danger of closing our doors,” Mark Palmer, president of the board of the nonprofit, said at a press conference. “I can tell you now that we have weathered that storm.”
SBNC operates three affordable health care clinics and a dental clinic on the South Coast. The nonprofit clinic network provides free or low-cost health care to uninsured and underserved members of the community, and it’s the only organization in the county to do so, excluding clinics that serve exclusively veterans or homeless individuals.

Since kicking off a 100-day plan to regain its financial footing, the organization received $600,000 in donations from a group led by the Santa Barbara Foundation. The funds were tied to monthly goals and the implementation of a strategic plan.

SBNC said that through a new operation plan, it will gain upwards of $1 million in cost savings per year.

At the same time, the organization recently received a large grant from The Health Resources and Services Administration, a federal agency, to open a new clinic in Goleta’s Old Town neighborhood. The funds are part of a Medicaid expansion under the Affordable Care Act and include an immediate grant of $812,500 plus annual funding of $650,000 starting in 2014. The nonprofit is currently looking for a facility of about 11,000 square feet to house the new clinic.

Palmer said SBNC has been able to make “a really positive transition” as a result of generous community support, combined with a new operating plan.

Trula Breuninger, who was brought in as interim CEO this summer, now holds that position on a permanent basis. She has previously served as CEO for community health care organizations including the San Diego American Indian Health Center and, most recently, the Southern Indian Health Council in Alpine, Calif. Breuninger received her MBA from the W.P. Carey School of Business at Arizona State University and a master’s degree in public health from UC Berkeley.

SBNC, which in May said it was in danger of closing its doors due to a funding crisis, said Nov. 21 that its new operational plan has allowed it to bring its monthly deficit down to $100,000 a month from $250,000.

Long-term, the group expects its funding gap to be about $75,000 a month or $800,000 a year, Palmer said. The deficit — the difference between the group’s operating revenues and its expenses — is the amount SBNC seeks in community support.

Breuninger said the group was able to cut costs in part by outsourcing some positions. SBNC had 103 staff positions when she started, she said; it now has 94.

SBNC said its turnaround comes at the same time that it is experiencing record demand for low-cost primary care. In October, the group’s clinics experienced record patient visits, with 5,187 people turning to the nonprofit for free or low-cost health care. SBNC’s dental clinic saw about 1,500 people, up from its usual monthly figure of 1,000 to 1,200 patients, executives said.

The clinics have averaged about 17,000 patient visits a year. About one-third of those patients are non-reimbursable, with SBNC receiving little or no revenue from either patients or the government.

Breuninger said the group believes that higher government reimbursement rates will kick in as a result of the clinics implementing electronic medical records. The organization also believes that with health care reform, many patients who had previously been ineligible for government funds will now become eligible, also resulting in more revenue for the clinics.

Cottage Health System paid for a consultant to help the Neighborhood Clinics devise a workable business model.

Zate, the Cottage spokesperson, said the low-cost clinics are an important part of the South Coast’s health-care industry. “The SBNC clinic setting is the appropriate place for many patients to receive primary care and is more cost-effective for the community than using a hospital emergency department for non-emergent care,” she said. “Having a medical home, with access to primary care providers, is important for improving the health of the underserved in our community.”

Trula Breuninger, MPH, MBA, CEO at Santa Barbara Neighborhood Clinics

November 27, 2013  |  Article, News  | 



SANTA BARBARA, CA, November 21, 2013— Santa Barbara Neighborhood Clinics (SBNC) is pleased to announce the permanent leadership of Trula Ann Breuninger, MPH, MBA, as CEO. Breuninger’s extensive experience as a leader of community health, as well as an operations management and planning professional consultant, makes her ideally suited to lead the organization. She has previously served as CEO for four

community healthcare organizations across the southwest including the San Diego American Indian Health Center and most recently, the Southern Indian Health Council, Inc., in Alpine, Calif.

As a consultant, Breuninger has performed the full spectrum of guidance to clients including operations management, strategic planning, feasibility and marketing analysis, and has helped to reduce costs and improve profitability. Her clients have included state and local governments, tribal governments, nonprofits, governing boards, universities, research institutions and integrated healthcare organizations.

“I am honored to lead SBNC and work with the Board of Directors and our dedicated Staff as Chief Executive Officer,” said Breuninger. “Our commitment to provide quality care and better the lives of our patients remains stronger than ever and I look forward to continuing our mission to bring the critical health care services SBNC provides the Santa Barbara community every day.”

Breuninger received her MBA from the W.P.CareySchool of Business at ArizonaStateUniversity and an MPH degree from the School of Public Health at the University of California, Berkeley. She received a Bachelor of Science degree in Nutrition from BrighamYoungUniversity.

Santa Barbara Neighborhood Clinics The mission of Santa Barbara Neighborhood Clinics is to provide high quality, comprehensive, affordable healthcare to all people, regardless of their ability to pay, in an environment that fosters respect, compassion and

dignity. For more information please go to


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Neighborhood Clinics Stabilized

November 27, 2013  |  Article, News  | 

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Once Troubled Community Clinics On South Coast Say They Are Now Back On Track Financially

November 22, 2013  |  Article, News  |  ,


Posted on Friday, November 22, 2013 12:19am

Some once financially troubled community clinics on the SouthCoast say they’re now back on track.

Officials with the Santa Barbara Neighborhood Clinics say they’ve trimmed $1.2 million dollars from their annual budget, and have taken a number of steps to increase revenue.

The three medical clinics, and one dental clinic say they’ve also seen a boost in patients, with the highest ever for a one month period.

And, Trula Breuinger, who was interim CEO for the clinics, and was just made the organization’s permanent CEO.

Topping off the good news is that thanks to a federal grant, the clinics will be able to open a new, 11,000 square foot facility in Goleta, with plans to have it in operation by March.

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Neighborhood Clinics Stabilized

November 22, 2013  |  Article, News  | 

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 Eastside Neighborhood Clinic (September 24, 2012)

Debt Reduced Significantly


Six months ago, Santa Barbara’s Neighborhood Clinics were in such dire financial straits that board president Mark Palmer held a press conference to announce they’d be shutting their doors unless they got a massive infusion of cash. Thursday afternoon, Palmer held a much calmer press conference to announce that while the clinics — which treat about 17,000 of the poorest and most underserved residents on the South Coast — may not be entirely out of the woods, the wolf is no longer at the door. Today, the clinics have cut annualized operating costs to the tune of $1.2 million. The clinics are still running in the negative — losing about $100,000 a month — but that’s far better than the $250,000 a month they had been losing, Palmer said.

Palmer credited $150,000 in individual donations the clinics received and a $600,000 package put together by Ron Gallo and the Santa Barbara Foundation. Particularly helpful, Palmer said, was a grant from Cottage Hospital to pay for a consultant specializing in helping troubled medical operations. That consultant helped prepare a detailed blueprint for economic recovery. Palmer also announced that the interim CEO the clinics hired — Trula Breuninger — has just been been hired permanently.

In the meantime, the clinics have cut costs and increased efficiencies by consolidating offices, laying off nine employees, and getting patients seen by medical professionals with less wasted time. This October, the medical clinics saw the second highest number of patients in its history. The dental clinic on Milpas Street also experienced a marked increase in traffic, accomplished by converting administrative office space into a dental theater.

One of the main problems confronting the clinics is that one-third of their patients have no money or insurance and that the federal compensation for such visits is — and has been — quite low. Palmer and Breuninger are currently working on plans to get that rate of compensation increased by $10 per visit. That process is quite daunting and byzantine and the outcome is by no means assured. Earlier, there was much discussion about whether the Neighborhood Clinics might merge with the American Indian Health center, which enjoys a significantly higher re-reimbursement rate for the same procedures than the clinics. But Palmer said, after closer examination, both entities agreed it made more sense for them to remain as they are.

Two weeks ago, the federal government awarded the Neighborhood Clinics an $800,000 grant to open a new clinic in Goleta with $600,000 in annual funds to pay for operations. The fate of the Neighborhood Clinics’ Isla Vista offices, however, remains very much up in the air. Those offices were located on real estate owned by a redevelopment district, and the state government abolished all redevelopment agencies. As a result, the state is pushing that this property be sold off. If that were to happen, the Isla Vista offices would be forced to find other accommodations. Currently, the county supervisors are fighting this liquidation.

Financial problems at the Neighborhood Clinics had been festering for years, but came to a head just as the constellation of South Coast health-care bureaucracies was about to be rocked by the onset of Obamacare. The good news is that Obamacare offers the possibility of new income streams, if the clinics could just hold on. But for other health-care providers — struggling to find enough primary care doctors to handle the spike in patients — the Neighborhood Clinics’ financial SOS was especially alarming. If the Neighborhood Clinics went under, local emergency rooms would have felt the impact.

Palmer took pains to praise his staff for holding tight and weathering the financial crisis. “Nobody went running for the doors,” he said. “It was all about rolling up their sleeves.”

Neighborhood Clinics Avoids Closure

November 22, 2013  |  Article, News  |  ,



With funds and new CEO, Neighborhood Clinics turn the corner

November 21, 2013  |  Article, News  | 


With New Funding, Santa Barbara Neighborhood Clinics to Open in Old Town Goleta

November 21, 2013  |  Article, News  |  ,

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The organization also welcomes permanent CEO Trula Breuninger as it continues to work toward improved fiscal health

12-3-2013 12-45-21 PMChief Medical Officer Dr. Charles Fenzi, left, Chief Dental Officer Dr. Quynh Nguyen and board president Mark Palmer speak Thursday on behalf of the Santa Barbara Neighborhood Clinics, explaining that the facilities saw more patients in October than ever before. (Giana Magnoli / Noozhawk photo)

By Giana Magnoli, Noozhawk Staff Writer | @magnoli | Published on 11.21.2013 10:12 p.m.

The Santa Barbara Neighborhood Clinics will be opening a new clinic in Old Town Goleta with federal Health Resources and Services Administration funding, board president Mark Palmer announced Thursday.

Its interim CEO, Trula Breuninger, who comes with a wealth of experience, has been named the permanent CEO for the organization.

Just six months ago, SBNC announced it may have to close its doors and asked for community support.

The Cottage Health System funded a consultant to develop a turnaround plan and a coalition of donors put in $600,000 between July and October as certain milestones were met. The clinics serve 17,000 patients a year on the SouthCoast.

SBNC has been cutting costs by moving out of the 1900 State St. offices, outsourcing and consolidating staff from 103 to 94 positions, and finding operational efficiencies, Palmer said.

The monthly deficit of $250,000 has gone down to $100,000, the lowest it has been in five years, he said. SBNC officials are aiming for about $75,000 per month, which is why they are asking for long-term community support.

It’s impossible for the clinics to break even or profit since federally-qualified health centers have to take every patient regardless of ability to pay, he said.

The clinics had the highest number of patient visits ever in October, with 5,187 patients and more than 1,500 dental visits. Of the medical visits, 33 percent were not reimbursable and had little or no revenue to the clinics.

The clinics are expecting more dental patients in the future, since adult dental benefits are coming back for Medi-Cal patients next May, said Dr. Quynh Nguyen, chief dental officer for the clinics. Only one or two private practice dentists on the SouthCoast accept Medi-Cal patients, she noted.

Clinics are actually looking forward to the Affordable Care Act, since they expect more patients to get covered by Medi-Cal. That way, more patients will provide reimbursements to the clinics. SBNC is trying to increase its reimbursement rate as well.

The new Goleta clinic comes with federal funding of $812,500 and annual funding of $650,000 starting next year, Breuninger said.

“It validates we are a clinic that’s here to stay,” she said.

Officials are currently looking for space — at least 11,000 square feet — in the OldTown area and will start with a small staff. The clinic has the potential to reach 37,000 unserved patients in that area, she said.

The $650,000 a year is for operational costs and it won’t be enough to sustain the new clinic, so SBNC will continue relying on community support, she said.

There was talk of merging with the American Indian Health Services clinic on Upper State Street, but the clinics ultimately decided it was better to stay separate, Palmer said. Breuninger is affiliated with the Navajo tribe and has experience with American Indian health centers across the Southwest, including as CEO for the San Diego American Indian Health Center and most recently the Southern Indian Health Council Inc.

Dr. Charles Fenzi, chief medical officer, said the clinics want to expand hours for better access and be open in the evenings. The three clinics on the Westside, Eastside and in Isla Vista are already open on Saturdays, as is the dental clinic on Santa Barbara’s Eastside.

Fenzi and Nguyen credited all the doctors and other providers for sticking with the clinics over the last six months, saying they didn’t lose any clinicians.

“No one headed for the door — everyone just rolled up their sleeves and went to work,” Palmer added.

SBNC is still waiting on a decision from the state Department of Finance on the Isla Vista Clinic building. It’s a former Redevelopment Agency property so the state has discretion whether to make the county sell it or be allowed to keep it.

The county Board of Supervisors is fighting to keep it, since it’s the only public-health clinic in that community of 22,000 people.

— Noozhawk staff writer Giana Magnoli can be reached at[email protected]. Follow Noozhawk on Twitter: @noozhawk,@NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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I.V. Neighborhood Clinic Is Here to Stay, Maybe

November 18, 2013  |  Article, News  | 

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Isla Vista Neighborhood Clinic stays in place for now thanks to a Health and Human Services grant and county supervisors’ attempts to hold on to the property.

Community and Government Work Together for Isla Vista

The property on which the Isla Vista Neighborhood Clinic sits is now a county-owned property, what used to be the site of St. Athanasius church, 970 and 881 Embarcadero del Norte. The county was told by the state to prove that the facilities were for government use or be forced to sell the properties, as part of the dissolution of the redevelopment agencies (RDA) in California. Another factor in considering the sale of the property was the financial hardship that the umbrella group, Santa Barbara Neighborhood Clinics, had gone through in recent times. When time came for the Board of Supervisors to make a decision, the organization received considerable funding, and the clinics’ future looked brighter.

To the Isla Vista and Goleta communities, it was pretty obvious that the closure of the I.V. clinic would affect thousands of families in the area, since the medical clinic saw about 1,000 patients per month. With all of this in people’s minds, the community lobbying poured out to the Board of Supervisors asking the supervisors to keep the clinic open. Finally, on October 15, 2013, the Board of Supervisors voted to keep the church building as well as the parking area and, of course, the clinic. This was great news. But the decision must pass the California Department of Finance, which is responsible for determining the fate of RDA projects.

Last week there was even better news: Congressmember Lois Capps announced that the Neighborhood Clinics had received an $812,500 grant from the Department of Health and Human Services. The grant will be used to establish and operate a clinic in Goleta in an effort to serve nearly 19,000 medically underserved people through January 31, 2015. Thereafter, Neighborhood Clinics will receive $650,000 per year.

The new clinic will serve 3,750 individuals and provide more than 13,500 medical, dental, and behavioral visits each year. The clinics’ team will also provide chronic disease management and preventive services, prenatal services, care for the homeless, and other services to address barriers to health and well-being.

Families in the I.V. area need more, not fewer services. A county report released last week documents Isla Vista as one of four areas in the county experiencing high poverty. Utilizing the church building as a family one-stop center in which families could find a variety of services essential for their lives, such as landlord-tenant mediation, immigration counseling, domestic violence solutions, rape crisis counseling, truancy prevention, information and services for victims of crimes, police crime prevention, parenting classes, and so on, plus the medical services offered by the clinic, is a greatly needed solution to this community’s many challenges.

These types of “service hubs” already exist in other counties, and they have proven to be a great asset for families and individuals living in those areas. We’re living in different times, and we need different solutions that are simultaneously creative and address the most imperative needs of the people.

Editor’s Note: This story has been changed to reflect that theI.V. clinic land is not yet saved; that decision rests in the hands of the California Department of Finance.