In the five-square-mile city of Lynwood, 15 clinics provide family planning services. Within five miles of Lynwood, there are about 150. All of the clinics compete for the same sources of funding, which means resources within each health center are stretched thin.

JWCH Women's Clinic in Lynwood (Kaitlin Parker)

Facilities like the John Wesley Community Health Institute’s Women’s Clinic in Lynwood are barely hanging on with no budget, even with the money bestowed on them when Martin Luther King, Jr./Charles Drew Medical Center closed in 2007.

After King shut down, the responsibility for health care in the area fell not only on major hospitals like St. Francis Medical Center but also on the multitude of small independent clinics spread throughout South L.A.

The women’s clinic would be even worse off if it hadn’t been for SB 474, the legislation that deferred funds to independent clinics so that they could help fill the gap in service created by King/Drew’s closure. The women’s clinic received the money because it provides primary care. If they were solely a family planning center, they would have received nothing, explained Brenda Sandoval, clinic’s director.

Sandoval worked hard to change the clinic’s name in hopes of receiving more funds and to let community members know that they provide services for men, too. The center is now on the books as the Wesley Health Center, but there’s no money to change the sign outside their clinic.

Sandoval’s clinic is located in a strip mall off Imperial Highway, sandwiched between an H&R Block and a nail salon. It’s open six days a week – three days for general care and four for family planning. Wednesday is the overlap day, and the clinic stays open an extra two hours.

To work towards the goal of seeing 24 patients a day for general care and 32 a day for family planning, the clinic employs two people to run the front desk, two community health workers to provide counseling and one doctor.

To comply with federal funding requirements, every patient who visits for family planning must see a counselor as part of her visit, even if she’s just picking up birth control. The next available primary care appointment is in February.

The goal is to have each patient in and out in under an hour, but Sandoval acknowledges that’s not particularly realistic. When pressed, she won’t say how long the average visit time is, but it’s clear that it’s several hours.

A family planning visit is an involved process. Before seeing the doctor, patients have to meet in a separate, private room to verify personal details like their address and income.

“I mean, private is a relative term because we have no real walls,” Sandoval said, looking up at the two-foot gaps between the walls and the ceiling, “but so far, it hasn’t been a problem.”

The spaces between the tops of the room dividers and ceiling continue throughout the entire clinic, including into the exam areas. A radio or television has to be blaring at all times to ensure doctor-patient conversations can’t be overheard. To bring the walls all the way up would require redesigning the ventilation and lighting systems.

The clinic is the poorest in the John Wesley system, Sandoval said. They’re moving to a new facility in January or February that will have 11 exam rooms, but for now, they must make do with three. The Lynwood center receives no public-private partnership funding and borrows money from other John Wesley clinics, like those in Norwalk and Bell Gardens.

“Our new building was supposed to open up a long time ago, but because all these technicalities with the city and the funding and all that stuff, when we applied for the PPP funds, it was at the new address. And because we haven’t moved yet, we cannot utilize those funds, so we’re pretty much stuck with no funding for this clinic.”

Operations at the clinic depend on money from California Family PACT program, HMOs, and Medi-Cal. The clinic used to take Expanded Access to Primary Care funding, which helped cover many of the patients who didn’t qualify for Medi-cal, but the state cut that funding last year.

In addition to being a part of the Family PACT program, the Lynwood center is a Title X site. Title X is the only federal grant program dedicated to family planning services. Funds from this grant help provide things Family PACT doesn’t cover, like additional condoms. They also help to cover services like STD screenings and treatment, breast and pelvic examinations, and educational programs.

Title X funds can’t be used in clinics that offer abortions. And to remain a Title X site, Sandoval has to complete a mountain of paperwork every month. She describes the amount they receive as “pennies,” only $114, 000 a year, and wonders if the minimal funds are even worth all the extra work they require.

Sandoval said the clinic has been in its current location for nine years. She doesn’t know what it was before John Wesley bought it, but, “it was clearly not a clinic.”

“I sit in this little closet here.” 

Someone recently donated several boxes of new maternity pants, but the clinic doesn’t work with obstetrics patients, so now, the overflowing boxes just take up space in the hallway. There’s no room for them in storage. There’s not an assigned space for the doctor to fill in patients’ charts, so he usually does it in the medication room.

At the moment, two medical assistant stand in the cramped space, filling prescriptions. Sandoval gestures to the door.

“That one’s supposed to be locked at all times, but we’re cheating right now.”

Sandoval predicts the funding from SB 474 will be pulled once King opens, but she’s not concerned. Most of their money comes from other grants anyway. Strained for resources as they are, Sandoval is proud of the quality of care her clinic is able to provide. “You should see some of the other clinics. This organization has the best care.”