Late last week, St. John’s Well Child and Family Center management learned they had
received the largest grant in the clinic’s history: $9.4 million from the Patient Protection
and Affordable Care Act, more commonly known as the healthcare bill. The grant equals
nearly half of St. John’s entire yearly operating cost.

St. John’s runs a network of clinics serving low-income residents throughout poverty-stricken communities of South Los Angeles, particularly near Compton, where the 2007
closure of Martin Luther King Jr./Drew Medical Center left a void for healthcare. Within
five miles of where King/Drew use to serve patients, there are 15 federally funded health
centers, according to the U.S. Department of Health and Human Services.

Most of the grant money will go toward building an additional clinic space next to St.
John’s existing flagship clinic in Vermont Harbor. Not only will the clinic allow more
patients to be seen, but specialists will be added in mammography, ultrasound and
radiology.

Hosting specialists on-site will begin to solve a big problem for uninsured patients,
who make up the majority of visitors to the clinic. For an uninsured patient, the wait to
see any kind of specialist begins at three months and can last up to six or more. Insured
patients wait just seven to 10 days, according to Gladys Uraga, who oversees referrals to
specialists at St. John’s in Compton.

Patients with serious conditions enter her office – housed within a renovated two-story building, once a crackhouse – to learn the county specialists are booked for months.

“There are lines that go for months in terms of getting into specialty care,” said Dr. Rishi
Manchanda, a primary care physician at the Vermont Harbor clinic. “…This is a huge
deal.”

Building plans are in the works. Under the grant conditions, the new clinic must be built
within two years.

“It’s going to be a modernized clinic,” said Jim Mangia, the clinic’s president and CEO. “Why should Beverly Hills get all the fancy clinics?”

The addition will allow St. John’s to provide for 15,000 more patient visits a year.

The federal funding comes at an opportune moment for St. John’s community health clinics, which were hard hit by the closure of King-Drew Hospital. After King-Drew closed, surrounding community health centers saw a 137 percent increase in visitors, according to Manchanda.

St. John’s in Compton, one of the network’s 10 clinics, is less than a mile away from King-Drew, along Wilmington Avenue. After the closure, clinic workers got the word out that the clinic would try to handle the fallout from King-Drew.

Though the health center cannot provide emergency care, it has been able to provide many medical services without forcing people to leave the community.

Representatives from the California Primary Care Association agreed that the community
suffered after the King-Drew closure, but they also said the closure helped people in the
area learn about other healthcare options.

Sean South, a media representative with the Primary Care Association, said many
hospital visits are not real emergencies. Patients tend to visit hospitals because they have
nowhere else to go, he said.

“We’ve seen a real spike in the use of emergency rooms. Part of our mission is to try to
work with hospitals to make sure that folks know there are other avenues to care. It can
be a long and involved process to get treatment,” South said.

When people visit emergency rooms, they often have to wait many hours before being
seen, and the payments are often higher. South said St. John’s provides community members
with a place to receive treatment even if they cannot afford health insurance.

Jerrell Hightower, the clinic manager at Compton, said their clinic has seen a significant
increase in patients.

“With the closure of King, our numbers have escalated. We’re seeing
15 to 20 more patients a day,” he said.

Marvin Atilano, who went to Compton for medical care as a young boy, is now a medical assistant at the clinic.

“I had one gentleman, actually, he used his entire 401(K) on medication before he realized we existed. He literally almost broke down in tears when he found out about us,” Atilano said.

Compton, like other St. John’s clinics, is known for its long lines. The clinic allows walk-
ins, and as a federally qualified health center, they must offer care on a sliding scale.
In Compton, that means most of the patients pay nothing at all, according to staff.

When Atilano arrives at work every day at 8 a.m., there’s already a line that
stretches across the center courtyard, nearly to the street. It begins to build at 5 a.m.

“By 9:30, I’m already on my 35th patient.”

Behind Atilano’s desk, a room of shelves is stuffed with children’s medical records. To reach the adult files, assistants have to jog up the stairs to a separate building, also overflowing with files – some neatly tucked away, others jammed into filing cabinets,
more still piling out of postal cartons.

Of the 65 to 80 patients the clinic sees each day, “there are 10 to 20 new patients we have
to add to the racks,” Atilano said.

In the small waiting room, “they get packed like sardines.”

Help has come to St. John’s Compton since King/Drew closed. Not all clinics have been so lucky, however.

“A lot of the free community clinics are disappearing. They are based on a good
economy. They get money from individual donors and foundations,” South said.

A study done by the Community Clinics
Initiative showed that most clinics’ weakest area is fund development. In
2009, community health centers lost $70 million in local funding statewide, plus another
$10 million this year. The money received from the healthcare bill is going to help St.
John’s and other health centers make up for the loss in revenue.

As California’s economy continues to struggle, many donors have decided they can
no longer afford giving money to clinics. South said St. John’s is lucky to still be
receiving grants and money from donors.

The recent healthcare bill aims to raise the nationwide count of total centers from 7,000
to about 14,000, according to Manchanda.

Though no federal funding is slated for the Compton clinic, it was supported by state
money, and by federal stimulus dollars. State Senate Bill 1409, sponsored by Senator
Curren Price, extended SB 474, a funding stream to community clinics of money
previously earmarked for King-Drew set to expire last June. SB 1409 extends funding to
June 2013.

With SB 474, the Compton clinic was able to add an additional doctor to the staff, but that didn’t mean they were able to meet the demand, said program coordinator Luis Rivera.

At the Compton clinic, stimulus money helped turn a crack house next to the clinic into an administrative and special programming house a year and a half ago.

Clinic workers and patients hope that more changes are on their way.

 

Reach reporter Emily Frost here, Dan Watson here, and Frances Vega here.