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HomeMy WebLinkAbout09/03/1992 BAKERSFIELD Kevin McDermott, Chair Patricia J. DeMond Ken Peterson Staff: John W. Stinson AGENDA BUDGET AND FINANCE COMMITTEE Thursday, September 3, 1992 12:00 Noon City Manager's Conference Room 1. State Mandated Fire Inspections (Steve Johnson) [Wendy Wayne to meet with Committee] 2. Community Development Block Grant Amendment/Clinica Sierra Vista (Jake Wager) [Steve Schilling to meet with Committee] 3. State Budget Update (John Stinson) 4. Year End Finance Summary (unaudited) (John Stinson) 5. Parking Rate Update (John Stinson) 6. Set Next Meeting MEMORANDUM September 3, 1992 TO: Alan Tandy, City Manager FROM: Jake Wager, Economic Development Director SUBJ: AMENDMENTS TO THE FINAL CDBG APPliCATION FOR FY 91 To comply with Housing and Urban Development (HUD) requirements it is necessary that whenever the scope or fund amount of CDBG projects change, public notification is required prior to City Council action. Due to certain changes in projects funded in the previous fiscal years an amendment has become necessary. Those projects include: Amendment No. 4 to FY 1991-92 Final Statement Proposes to Amend Two Existing Projects: Budget Final Increase Budget I. Housing Development Assistance Program Proposals from viable developers and non-profits to construct ($80,000) $0 or rehabilitate permanent or Wansifional housing projects were not submitted. New funds are available in Current budget. 2. Fire Station #2 Improvement Pro~zt :" This project will be funded with City's C)enerai Fund. ($ ,860) $12,140 3. Clinica Sierra Vista Clinic - ~,.: 'i:%' · · Land acquisition of properties location on Talreview Avenue $0 ': $107,590 between Clarendon Street and Potoma6 Avenue for the conslmcfion ::'.~-.. :'::: ::i:.: ,.. of a $1.5 million Health Cam Facility. ~ ?' ..~¥.., ,... ','. 4. Tulare Street Curb & Gutter Inffll curb and gutter for the area bounded by Bernard Street, $0 '" $ 91,420 Kern Street, Highway. 178 .and Inyo Street totaling $91,420. ,..:. NOTE: This Amendment will program $41,150 of fund balance not previously funded in the 1990-91 CDBG Application. "'>~' ' : · - 5'? .. 'The East Bakersfield Community Health Center Construction Project Executive Summary The East Bakersfield Community Health Center (EBGHC), owned and operated by Clinica Sierra Vista, is an existing facility currently located at 234 Baker Street, Bakersfield. This medical facility provides comprehensive primary care sen/ices to the Iow-moderate income populations residing in the southeastern urban areas of .metropolitan Bakersfield. Clients have aCcess to a multi-speciality medical practice which includes Family Practice, Pediatrics, Internal Medicine and OB/GYN, as well as other on-site sen/ices such as lab, pharmacy, per/natal care and education classes, 'substance abuse per/natal counseling, individual and family counseling, nutritional counseling and education classes, WIC (Women, Infants & Children) supplemental food program, HIV testing and counseling, and healthcare services for homeless clients with chronic medical problems. EBCHC first opened its doors in 1984 and since that time has seen tremendous groWth and demand for services. Today, EBCHC's current facilities can no longer accommodate the growth and staff are having to make hard decisions on how many new patients each service is able to accommodate. To resolve this situation and to keep pace with the demand for sen/ices by the ever-growing population, Clinica is proposing to construct a new $1.5 million,' 10,000-15,000 sq. ft. medical complex providing enhanced primary care, preventive and education services on -site. C/inica is currently reviewing available property, that is minimally I 1/2 - 2 acres in size to accommodate the proposed facility and parking requirements. Property meeting these expectations has been identified in the Lakeview area situated on Clarendon and Lakeview streets and allows the EBCHC to continue to provide sen'ices in its current service area. This property is partially owned by the City and by three other private owners. We are proposing to the Bakersfield Community Development Corp. that they assist in the acquisition of this property and grant the property to Clinica. This award lends the equity needed when Clinica applies for County CDBG funds and for other construction monies. This partnership will bring the needed "shot-in-the-arm" to the revitalization of the Lakeview area, and we look forward to being a "pathfinder" in this endeavor. Attachment E Clinica Sierra Vista is a non-profit organization receiving federal funds from Section 329 (Migrant), Section 330 (CHC), and Section 340 (Homeless) of the Public Health Services to assist in subsidizing revenue sources. It was created out of the unmet health care needs of migrant and seasonal farmworkers. The Kern County Health Committee, Inc. was prompted in creating the program primarily because of the inaccessibility of farmworkers to primary health care resources. In 1971, Clinica de los Campesinos, a non-profit corporation based in Lamont, began providing services to the area's population, housed in a trailer situated in the park. In 1972, the program was moved to a storefront building, and in 1975, a permanent facility was constructed and the organization's name changed to Clinica Sierra Vista, Inc. 1973-1977proved to be a dramatic growth period in which the service area of Clinica Sierra Vista (Lamont/Arvin) was designated as a Health Manpower Shortage Area (HMSA), allowing the area to be eligible for physician staffing from the National Health Service Corp (NHSC); two education/preventive programs - Women, Infants and Children (WIC) and the Maternal Child Outreach Program (MCOP) - were brought on board; a computer system to handle accounting processes and data gathering was implemented; and a special grant to initiate dental services was received. A dental facility was completed and services began in 1977. During 1978-1981, the computer system was upgraded to an IBM-34 to provide additional data capabilities, an additional 5,000 sq. ft. was constructed to accommodate expanding programs and services in medical, WIC, and accounting, and the Lamont/Arvin area was designated as a Dental HMSA~ allowing the recruitment of NHSC dentists. In 1978, the computer system was again upgraded, to an IBM-38, to provide on-line capabilities to all satellite clinic sites. To date, Clinica Sierra Vista, Inc., operates six centers, .and oversees operations of the Toiyabe Indian Health Service program as requested by the federal government. The first satellite clinic opened in 1978 and was named the Frazier Mountain Community Health Center, providing full-time medical care to the isolated rural communities of Frazier Park and Lebec. This particular area is unique in that it is a one person provider clinic for the entire service area and there are no hospitals in the immediate vicinity. The physician practicing at this satellite is truly the "hometown doc". The second satellite, the Kern River Health Center, opened in 1982. Originally located in the Kemville area and operating out of two modular buildings, the growth in patient population and services created the need for a larger, more modem facility. In 1989, the center moved its operations into a new 7,000 sq. ft., $1.2 million facility located in Wofford Heights. The new facility now accommodates increased exam rooms, laboratory, x-ray, future pharmacy, and a large conference room available to community groups for use. The third satellite clinic, the East Bakersfield Community Health Center, located in southeast urban Bakersfield, opened in 1984. Funding for this site was initially received from the Jobs Bills, but has since been declared a Medically Underserved Area (MUA) and reCeives funding under the Community Health Center program. During 1987, increased growth in patient population resulted in a substantial remodeling of the 10,000 sq. ft. facility to accommodate expanded services and programs. Our fourth site is the Death Valley Health Center located in Shoshone, Inyo County. In 1985, we were contacted by the Death Valley Health Center which had recently separated from its sponsoring organization, at which time we officially became their grantee .and operator. This "frontier' rural site serves a vast area encompassing Death Valley National Monument and Southern Inyo County with patients traveling 100 miles to receive medical care at Death Valley Health Center. Currently, the community and staff are beginning the process to renovate and remodel a permanent, larger facility. Completion will be mid-1992. The McFarland Community Health Center became our fifth satellite clinic and began services in 1988. With increased media focus on the "cancer clusters" in McFarland, a side-effect was also the illumination of the lack of accessible health care services to the community area. As a result of this attention, we were approached by the community and the State in providing primary medical services. The McFarland Community Health Center was granted "intermittent" status permitting the facility to be opened one day per week, after securing public/corporate donations and State Funding. In 1989, the center's operating hours expanded to three days per week in order to accommodate the demands for primary care services from the community area. Currently, we are working towards securing permanent funding to provide continued services of the McFarland Community Health Center. The Indian Health Services program we monitor is the Toiyabe Indian Health Program, operating three locations (Bishop, Lone Pine, and Coleville) in the Owens Valley of Eastern Sierra. Since 1985, we have been asked by DHHS to assume Partial responsibility for the non-Indian operations of this project. Demographically, our patients are ethnically composed of Hispanic, Caucausion, Black, Indochinese, Native 'American, Arab, Philippine,. and Indian; and are Iow to moderate income, often benefitting from our sliding fee scale. All sources of payment are accepted including Medi-Cal, Medicare, and private insurance. Programs and services which are in place to meet the growing needs of our patients are comprehensive primary medical services, dental services, pharmacy,. laboratory, x-ray, WlC (Nutrition), Clinical Nutrition, MCOP.(prenatal care), Information & Education (teen family life education), FCCS (family coUnseling), child abuse treatment/prevention, pregnant substance abuse patients, HIV education and testing, homeless health care, social services and transportation. The history of Clinica Sierra Vista, Inc. has shown enormous growth since its inception 20 years ago and as we look to the future, we stdve to remain innovative and creative in our delivery of services and diversity of programs to meet the needs · and demands of our patients. Clinica Sierra Vista is required by the mandates of federal and state funding to provide services in a non-religious and non-political fashion. Clinica Sierra Vista is experienced in receiving numerous federal, state and local grants. FUNDING SOURCES FY 1991/1992 Contract/Grant allocation Source $ Amount US Public Health Migrant (329) Rural Health Initiative (330) Federal $2,131,479 Homeless Program (340) Federal 101,665 Office of Family Planning, Title XX State 79,475 Office of Family Planning, I&E State 89,000 Smoking Cessation, Prop 99 o State 24,833 Women, Infants and Children State .863,699 Office of Family Planning, HIV State 51,929 MCH, Black Infant Project State 3,263 OCAP-Perinatal Substance Abuse State 71,900 AB75/Prop 99 State 252,069 CAPIT ., State 35,968 United Way Local 5, 000 Kern County HIV/AIDS Consortiurn~ Local 5,360 Kern Medical Center, CPSP Program Local 111,215 AIDS ' Local 5,500 Mission Statement It shall be the Mission of Clinica Sierra Vista, ~lnc. to provide quality comprehensive primary and preventive health care services at the most efficient cost to the underserved populations of Kern and Inyo Counties regardless of ability to pay, and to seek necessary resources to meet the. growing health care demands while maintaining the corporation's financial integrity. We strongly believe in everyone's right to quality health care; therefore, no one is denied services based on race, religion, ethnicity, sex, age, disability, or economical status. Goals of Clinica Sierra Vista, Inc. To provide quality, comprehensive primary care promptly and courteously, to our · medically underserved populations, especially the migrant and seasonal farmworkers. To assure that no patient is ever refused necessary health care services by reason of his or her ability to pay. To promote the well-being of the patients we serve. To provide efficient and effective management in the achievement o/ our goals. To operate under strict budgetary controls. .' To foster employer-employee relations by providing leadership that inspires innovation, productivity, and teamwork. To maintain our unique character as a non-profit corporation gove.rned by a majority of health consumers. Clinica Sierra Vista, Inc. has not nor anticipates entering into litigation with the City. SUNSET TRACT SCHOOL DIST. /-/~-~ 19-14- ~ (~ I I I ~ L_ ~ C£ ,4R£1VDO/V .,CT , , ~ ~ ,, ~ ,, ~ ~,. Il I I I~ I I I I · ~ ASSESSORS MAP NO..!.~.:J.~. ............ ~ COUNTY OF KERN health services for the community1971' '1991servicios para la comunidad August 28, 1992 Bakersfield Community Development Corporation · ~'O~.%_/ Mr. George Gonzales, Coordinator ~.,~ '~/~' City of Bakersfield 515 Truxtun Avenue /~E'i,,'~ ~ co, f, Bakersfield, CA.. 93301 ~, Dear George: I would like to bring you up-to-date on our progress in the EBCHC/Lakeview Project. Clinic Sierra Vista intends to pay for the construction (approximately $1.5 million dollars) from revenues generated from operations. We have done this on three other occasions and own our facilities in Lamont, Frazier Park, and Kern River. We have never missed a loan repayment and the only Indebtedness is a" small Farmers Home Administration loan on the Kern River Health Center facility. rve attached to this'letter pages from our annual CPA audit. Clinica Plans to pursue two different lending sources for the construction of this project. First, we are exploring with a consultant the funding available specifically for health facilities through the Cai Mortgage Program. This is iow cost financing specifically available for primary care facilities and hospitals and would be very appropriate for use in the construction of a new East Bakersfield Community Health Center. Secondly, we are also talking to representatives of Money Measures who help secure funding for community facilities through the Issuance of Certificates .of Participation. Through this proposal we would need to approach the County of Kern to ascertain their Interest In serving as a guarantor for~those certificates. I Intend to .do so. We have now secured the services of Victor R. Fabionar, an Architect we have used previously for the design of our Lamont and Frazler Park facilities. 8787 hall road · p.o. box 457 · lamont, california 93241 TEL (805) 845-3731 · TDD (800) 342-5833 ° FAX (805) 845-4511 Satellite Clinics Frazler Mountain Community Kern River East Bakersfield Community McFarland Community Death Valley Health Center Health Center Health Center Health Center Health Center Mr. George Gonzales August 28, 1992 Page 2 He will be developing a design only. package for us, to Include a'site plan and floor plan. The market value of net-owned assets of Clinica Sierra Vista, Inc. are approximately $8 million dOllars. We are one of the largest Rural/Urban/Frontier Community Health Center systems in the country regularly receiving evaluations from DHHS placing us in the top 8% of all like programs in the country. We have an excellent track record of performance nowin excess of 20 years. I've enclosed a copy of our 20 yea'r annual report which should provide for you and the City Council a better understanding of our program. . I would like to attend future meetings of the Lakeview Task Force and would appreciate it if you would please let me know when those meetings are held. Additionally, I feel strongly that my attendance at the next Budget and Finance Committee meeting on September 3rd is required in order to adequately answer any questions that might arise as to oUr position in this project. If you have any additional questions, pleaSe do not hesitate to contact me at 845-3731. Sin. cerely, Executive Director ~ SWS:ers TANNER AND WREN CERTIFIED PUBLJC ACCOUNTANTS · AMERICkN IN~-'Tr'ruTE OF 1701 WES~IND. SUITE t26 C~IFORNIA SEI~ OF P.O. BOX 1737 CERTIFIED PUBLIC ACCOUNTANT~ CER~ED ~UB~C ACCOU~AN~ BAKERSFIELD. CALIFORNIA 93302-1737 .TELEPHONE (BO5) 325-5115 TELECOPIER (805) 325-~27 INDEPENDENT AUD[TORS~ REPOR~ Board of Directors Clinica .Sierra Vista Lamont, California We have audited the accompanying Balance Sheet-Statutory Basis of Clinica Sierra Vista as of March 31, 1991 and 1990, and the related Statements of Changes to Fund Balances-Statutory Basis, Revenue .and Ex.penditures-Statutory Basis and Changes in Financial Position- Statutory Basis for the years then ended. These financial statements are the responsibility of managementl Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material'misstatement. An audit includes assessing the accounting principles.used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. As described in Note 1, these financial statements were prepared in conformity with the accounting practices prescribed or permitted by the Department of Health and Human Servic'es, which As a comprehensive basis of accounting other th'an generally accepted accounting principles. In our opinion, the financial statements referred to above present fairly in all material'respects, the' Balance.Sheet-Statutory Basis of Clinica Sierra Vista as of March 31, 1991 and 1990, and the results of its operations'and changes in its financial position for the years then ended, on the basis of accounting described in Note 1. -5- Board of Directors Cl. inica Sierra Vista July 31, 1991 our examination was made primarily for the purpose of formul~ating an opinion on the Balance~ Sheet-Statutory Basis, Statement of Changes to Fund Balances-Statutory Basis, and the Statement of Revenue and Expenditures-Statutory Basis, Although not considered necessary for fair presentation of revenues, expenditures and changes in fund balances, the financial data applicable to Schedules 1 through 3 of this report for the period April 1, 1990 to March 31, 1991 are presented for supplementary analysis purposes. The information contained in Schedules 1 through 3 was subjected to the same auditing procedures applied in our examination of the Balance Sheet-Statutory Basis, Statement of Changes to Fund Balances-Statutory Basis, and the Statement of Revenue and Expenditures-Statutory Basis, and is, in our opinion, fairly stated in relation to Exhibits A through D taken as a whole. This report is intended for the information of management and the U.. S. Department of Health and Human Services. This restriction is not intended to limit the distribution of the report, which is a matter of public record. Tanner & Wren Certified Public Accountants July 31, 1991 _6_ CLINICA SIERRA VISTA BALANCE SHEET-STATUTORY BASIS MARCH 31, 1991 AND 1990 ASSETS .. March 31, March 31, 1991 1990 Current Assets Cash in Bank and on Hand, Note 2 $ 1,277,405 $ 402,527 Accounts Receivable, Note 3 738,115 885,490 Federal Grant Funds Receivable 8,805 186,872 Deposits -0- 940 Total Current Assets 2,024,325 1,475,829 Investment in Land, Building & Equipment, Note 4 3,322,'701 3,215,518 Other Assets Note Receivable, Note 5 50,000 50,000 $ 5,397,026 $ 4,74'1,347 LIABILITIES AND FUND BALANCE Current Liabilities Accounts Payable $ 255,111 $ 397,975 Vacation/Sick Leave Payable, Note 6 107,093 138,638 Unemployment Insurance Payable, Note 7 258,347 241,448 .Toiyabe Contract Payable, Note 8 -0- 86,701 Credit Line Note Payable, Note 9 -0- 110,000 'Deferred Revenue, Note 10 83,173' 201,877 Current Portion of Long-Term Debt 50,000 50~000 Total Current Liabilities 753,724 1,226,639 LonE-Term Liabilities Mortgages'Payable, Note 11 963,593 1,006,658 Contract Payable, Note 12 -0- 10,457 963,593 1,017,115 Less: Current Portion (50,000) (50,000) Net Long-Term Liabilities 913,593 967,115 Fund Balances, Exhibit B ' 3~729,709 2,547,593 $ 5,397,026 $ 4,741,347 EXHIBIT A The accompanying notes are an integral part of these statements., -7- CLINICA SIERRA VISTA STATEMENT OF CHANGES TO FUND BALANCES-STATUTORY BASIS FOR THE YEARS ENDED MARCH 31, 1991 AND 1990 March 31, March 31, 1991 1990 Land, BUilding & Equipment Fund Balance at Beginning of Year, April 1 $ 3,215,518 $ 3,199,514 Add: Acquisitions During the FisCal Year, Note 4 118,394 257,831 Less:Deletions During the Fiscal Year,. Note 4 (11,211) (241,827) Balance at March 31 3,322,701 3,215,518 General Fund ' Balance at.Beginning of Year, 'April 1 (667,925) (664,920) Add: Revenue in Excess of Expenditures, Exhibit C 1,074,933 3,516 Less: Disallowed Expenditures Relative to Women,. Infants and Children Program Audit Conducted by State of California Controller's Office (DHS-WIC) for periods ended September 30, 1987 and September 30, 1988 (6,521) Balance at March 31 407,008 (667,925) Total Fund Balances at March 31 $ 3,729,709 $ 2,547,593 EXHIBIT B The~aecompanying notes.are an integral part of these statements. --8-- CLINICA SIERRA VISTA STATEMENT OF REVENUE AND EXPENDITURES-STATUTORY BASIS 'FOR THE YEARS ENDED MARCH31, 1991 AND 1990 March 31, March 31, 1991 1990 Revenue Program Revenue, Schedule 1 $ 7,730,162 $ 6,036,261 Donations 3,276 38,368 Interest Income 38,390 24,252 Sale of Equipment , 200 -O- Miscellaneous Income 7,384, -0- Total Revenue 7,779,412 6,098,881 Expenditures Personnel 3,698,654 3,314,711 Fringe Benefits 878,747 610,754 Travel 68,770 60,852 Equipment, Note 4 90,120 142,680 Supplies 802,983 717,358 Consultant & Contract Services 396,021 443,971 Space Costs 256,480 216,690 Construction, Note 4 28,274 115,150 Insurance 130,368 122,368 Interest 63,995 58,943 Patient Refunds 11,084 6,544 Collection Fees 5,773 6,337 Equipment Rent 23,766 28,378' Publications 5,705 3,821 Printing 43,868 42,575 Dues and Subscriptions 28,961 15,510 Licenses 7,325 4,057 Equipment Repairs 12,991 17,062 Board Expense 6,682 5,010 Telephone ~ 60,815 60,959 Postage 32,'132 36,632 Freight ~ 7,154 5,260 Recruitment and Training 33,~09 50,458 Other Operating Costs 10,702 9,285 Total Expenditures 6,704,479 6,095,365 Revenue in Excess of Expenditures $ 1,074,933 $ 3,516 EXHIBIT C The accompanying notes are an integral part of these statements.' --9-- CLINICA SIERRA VISTA STATEMENT OF CHANGES IN FINANCIAL POSITION'STATUTORY BASIS FOR THE YEAR ENDED MARCH 31, .1991 Source of Funds Revenue in Excess of Expenditures $ 1,074,933 Add (Deduct) Items Not Affecting Working Capital Capital Improvements and Equipment Purchases (Net of Disposals) 107,183 $ 1,182,116 Application of Funds Increase in Land, Building and Equipment (Net of Disposals) 107,183 Decrease in Mortgages and Loans 53,522 160,705 Increase in Working Capital $ 1,021,411 CHANGES IN WORKING CAPITAL Current Assets - Increase (Decrease) Cash in Bank and.On Hand $ 874,878 Accounts Receivable (147,375) Federal Grant Funds Receivable (178,067) Deposits (940) 5~8~496 Current Liabilities-Decrease (Increase) Accounts Payable 142,'864 Vacation/Sick Leave Payable 31,545 Unemployment Insurance Payable (.16,899) Toiyabe Contract Payable 86,701 Credit Line Note Payable 110,O00 Deferred Revenue 1'18,704 472,915' Increase in Working Capital $ 1,021,411 EXHIBIT D The accompanying notes are an integral part of these statements. -10-' CLINICA SIERRA VISTA STATEMENT OF PROGRAM REVENUES'STATUTORY BASIS FOR.THE YEARS ENDED' MARCH 31, 1991 AND 1990 March 31, March 31, 1991 1'990 Federal Grant-Department of Health Servioes, Note 14 $ 2,141,609 $ 2,041,163 Medical and Dental Fees Private Patients 788,602 855,577 Medi-Cal 1,666,253 897,599 Medicare 290,062 324,352 Private Insurance 324,363 276,215 Family Planning.Program 74,244 48,510 Information & Education Program 62,499 46,100 Child Health & Disability Prevention Program 269,183 209,627 Maternal and Child Outreach 77,651 264,155 McFarland .Health Center Grant 33,793 162,874 Women, Infants & Children 646,775 485,527 State AIDS Program 40,230 41,500 County AIDS Program 26,588~ 21,528 State Legislation Impact Assistance Grant 143,646 288,399 County Child Abuse Prevention Program .30,499 22,395 State Child Abuse Prevention Program 130,566 31,639 Proposition 99 - EPAC 770,825 -O- Proposition 99 - Tobacco Cessation 41,915 -0- Proposition 99 - County Grant 149,500 -0- Area Health Education Council Grant 5,500 -0- County Health - X-Ray Services 4,465 6,325 Pesticide Screening. 3,'074 5,424 Other Programs 8,320 7~352 $ 7,730,162 $ 6,036,261 " SCHEDULE 1 The accompanying notes are an integral.part of these statements. -11- CLINICA SIERRA VISTA NOTES TO FINANCIAL STATEMENTS MARCH 31, 1991 AND 1990 Note 1 - Basis 'of Accounting The financial statements are presented in conformity with the accounting practices prescribed or permitted by the U.S.. Department of Health and Human Services for grantee agencies receiving federal financial assistance, which is a comprehensive basis of accounting other than generally accepted accounting principles. Specifically, capital asset purchases and construction have been reflected in the financial statement as expenditures in the year of purchase. The Department of Health and Human Services requires this method in order to accurately match program expenditures with grant revenue. March 31, March 31, Note 2 - Cash in Bank. and On Hand 1991 1990 Petty Cash Fund $ 1,300 $ 1,200 Cash in Bank, Operating Account 587,328' 6,030 Cash in Bank, Donation Account Clinica Sierra Vista 3,7i8 2,683 Cash in Bank, Donation Account Frazier Park 214 204 Cash in Bank, Donation Account McFarland 53,410 77,861 Cash in Bank, 'Donation Account Kern River 1,229 2,396 ~Cash in Bank, Blue Cross Claims 6,061 -O- Cash in Bank, Savings - Reserve for Unemployment Insurance 104,444 178,493 'Cash in Bank, Savings - Reserve for F.M.H.A. Mortgages 44,700 33,841 Cash in Bank, Savings - Reserve for Construction 16,407 31,124 Cash in Bank, Savings - W.I.C. ~' Advance Payment 106 68,695 Cash in Bank, Savings 458,488 -O- $ 1,277,405 $ 402,527 -15- NOTES TO FINANCIAL STATEMENTS, continued March 31, March 31, Note 3 - Accounts Receivable 1991 1990 Family planning Program $ 35,330 $ 11,550 Medi-Care 37,113 133,044 Medi-Cal/Denti-Cal 288,160 228,384 Child Health and Disability Prevention Program 32,292 17',434 Women, Infants.and Children's Program 134,270 93,033 Maternal Child Outreach Program -0- 68,140 Family Planning - Information & Education Program 12,294 11,552 Private Insurance 48,950 125,966 State AIDS Program 11,855 10,690 County AIDS Education Program 1,326 5,003 State Child Abuse Prevention Program 26,649 31,639 County Child Abuse Prevention Program 9,187 9,714 State Legislation ImpaCt Assistance 83,713 139,341 Kern Medical Center - C.P.S.P. 9,114 -O- PropoSition 99 - Tobacco Cessation 7,714 -O- Other 148 -0- $ . 738,115 $ 885,490 Note 4 - Land~ Building and Equipment Balance Balance March 31, 4-1-90 through 3-31-91 March ~1, 1990 Additions Deletton~ 1991 Land & Landscaping $ 109,722 $ $ $ 109,722 Buildings 2,160,120 28,274. 2,188,394 Equipment 945,676 90,120 11,211 '1,024,585 $3,215,518 $ 118,394 $ 11,211 $3,322,701 The cost of buildings and equipment has been reflected as an expenditure in the current and preceding periods.. Therefore, no allowance for depreciation has been Provided. .~lso, see Notes 1 & 13. NOTES TO FINANCIAL STATEMENTS, continued Note 5 - Note Receivable Description Terms Amount Interest Only Clinica Mutual Prime Plus 2% Insurance Co. All Due 10/8/92 $ 50,000 ~ Note 6 - Vacation/Sick Leave Payable Clinica Sierra Vista is obligated to remit in the form of wages accrued vacation time to terminating employees. Note 7 - Unemployment Insurance Payable Clinica'Sierra Vista is self-insured with respect to unemployment insurance required bylaw to be provided to certain terminated employees. Each calendar quarter the amount otherwise required to be paid t° the State of California to administer this program is accrued as unemployment~insurance payable. Actual unemployment claims~ ~ are paid directly by Clinica Sierra Vista as they arise, and the accrued payable is accordingly reduced. Note 8 - Toiyabe Contract Payable Clinica Sierra Vista is the recipient of Federal funding in support of a subcontract with the Toiyabe Indian Health Project. In its year-ended March 31,. 1990 the grantee received $145,728 to be subcontracted during the period December 1, 1989 through March 31, 1991. In order to properly match revenues with expenditures, the whole amount of the subcontract with the Toiyabe ~'Indian Health Project has been'-accrued as an expenditure in the period ended March 31, 1990. Note 9 - Credit Line Note. Payable March 31, March 31,. 1991 1990, Prineipa1 Principal Lender Terms Balance Balance Interest Only National Cooperative NCB Base Plus 1.5%' Bank All Due'4/l?/90 $ -0- $110,000 NOTES TO FINANCIAL STATEMENTS, continued Note 10 - Deferred Revenue Department of Health and Human 'Services,-Health Services for the Homeless grant funds for the period ending April 30, 1991 for which a rateable portion is considered unrecognized in the period under examination. See also NOte 14~ '~ 8 726 Department of Health and Human Services contract funds for the Women, Infants and Children's Program for the contract period ending September 30, 1991 advanced to Clinica Sierra Vista in order to reduce billing time cycle ......... $ 74,447 ... $ 83,173 Note 11 - Mortgages Payable The following are mortgages on property owned by Clinica Sierra Vista. March 31, March 31, . 1991 1990 Principal Principal Lender Property Balance Balance Farmers Home Lamont Facilities Administration 'Additions $ 290,234 $ 301,095 Farmers Home Kern River Facilities Administration Building 673,359 705,563 $ 963,593 $1,006,658 Note 12 - Contract Payable March 31, March 31, 1991 !990 Principal Principal Lender Property/Terms Balance Balance Automobile-S339 per Kern Central month for 60 months Credit Union ~ 9.75% interest $ -0- $ 10,457 -18- NOTES TO FINANCIAL STATEMENTS, continued Note 13 - Land,'Building & Equipment Fund Th'e Balance Sheet (Exhibit A) reflects an investment in~ Land, Buildings and Equipment of $3,322,701 at March 31, 1991 and $3,215,518 at March 31, 1990. A contra-account for these amounts has been included in %he Fund Balance (Exhibit B). This account represents the 9ceumulation of all costs which to date have been reported as expenditures for this classification. In the same manner, the accumulation of these amounts has been reduced in the case where asset deletions have occurred. Since these costs have been reflected as expenditures in the period in which they were incurred, depreciation on the assets to which they relate is not provided. Note 14 - Federal Grants Description Grant Number Amount 'Migrant Health/Community Healt'h Center CSH-901577-11 $2,032,183 Health Serv%ces for the Homeless 09H-001826-03 109~426 $2,141,609 In the fiscal year ended March 31, 1990, Clinica Sierra Vista was the recipient of a grant award of the Department of Health and Human Services for the purpose of providing health-care to the homeless. The Health Services for the Homeless Award Notice (09H-001826-03-01) issued 'March 26, 1990 for the project period January 1, 1990 through December 31, 1990 approved a grant of $73,670. Supplemental Health Services for the Homeless Grant Awards under the same grant number (09H-001826-03). were issued in the following amounts: Grant No. Issue Date Amount 09H-001826-03-02 May 7, 1990 $ 2,579 09H-001826-03-03 September 27, .1990 6,320 09H-001826-03-04 October 22, 1990 12,641 09H-001826-03-05 December 20, 1990 6~455 $27,995. -19- Note - 14 Federal Grants, continued On December 19, 1990 the Department of Health and Human Services issued a Health Services for the Homeless grant notice (09H-001826-03-06) in the amount of $34.,905 for the project period January 1, 1990 through April 30, 1991. A recapitulation of the recognized revenue from the Health Services for the Homeless grant is as follows: Grant No. 09H-O01826-03-01 Original Grant Award $73,670 Proration for Number of Months Within Examination Period x 9/12 $ 55,252 Supplemental Grant Awards 27,995 Grant No. 094-001826-03-06 Original Grant Award 34,905 Proration for Number of Months Within Examination Period x 3/4 26,179 $109,426 Lamont, California 20 YEARS OF HEALTH SERVICES FOR THE CO'MMUNITY 1971-1991 Center Locations Clinica Sierra Vista Kern. River Health Center McFarland Community 8787 Hall Road 67 Evans Road Health Center P.O. Box 457 P.O. Box 1062 306 Lockwood Avenue Lament, CA 93241 Wofford Heights, CA 93285 McFarland, CA 93250 (805) 845-3731. (619) 376-2276 (805) 792-3038 Frazier Mountain Community East Bakersfield Community Death Valley Health Center Health Center Health Center Old Highway 127 3545 Mt. Pines Way 234 Baker Street P.O. Box 158 · P.O. Box 207 Bakersfield, CA 93305 Shoshone, CA 92384 Frazier Park, CA 93225 (805) 322-3905 (619) 852-4383 (805) 245-3773 'INYC COUNTY ~ Gamp ^ntol ,~ Bishop ~ ~ Lone KERN COUNTY o McFarland oWofford Heights .~ Toiyabe Indian Health Project - Bakersfield o o Lament L o Frazier Park · Mission .... · It shall be the Mission .of Clinica · Sierra Vista, Inc. to provide quality · comprehensive primary and · preventive health care services at the most efficient cost to the underserved · populations of Kern and Inyo · Counties regardless of ability to pay, · and to seek necessary resources to · meet the growing health care · demands while maintaining the · corporations financial integrity. We strongly believe in everyone's · right to quality health care; therefore, · ' no one is denied services based on' · race, religion, ethnicity, sex, age, · disability, or economical status. · Goals .... · To provide quality, comprehensive · primary care promptly and · courteously, to our medically · underserved populations, especially · the migrant and seasonal farmworkers. · To assure that no patient is ever · refused necessary health .care · services by reason of his or her ability · to pay. · To promote the well-being of the · patients we serve. To provide efficient and effective · management in the achievement of · our goals. · To operate under strict budgetary · controls. · To foster employer-employee · relations by providing, leadership that inspires innovations, productivity, and · ' teamwork. George Laven, MD, Medical Director (left) and Stephen W. Schilling, Executive Director (right). A £E'.-'i'ER FROM OUR DIRECTOR... "We have come a long way in Dentists, midlevel practitioners, women, and the mothers who 20 years. When we started we lab, x-ray and pharmarcy .staff bring their babies. ~'he families. were named Clinica de Los round out our clinical teams, whO count on us for their health Campesinos in a trailer in one Care. The homeless who seek of Lamont's Parks. Today our Our Women, Infants, and our services. The elderly who main clinic is a modern 22,000 Children (WIC) program issues .rely on our support. To all of square foot facility with five more than 9,000 food vouchers them we offer our thanks, you satellite centers in Kern and each month in Kern County to are our reason for being here. Inyo Counties. In 1991 we had recipients. This ranks us. over 72,000 medical and dental number two in California Another important thank you visits at our centers with an Community Health Centers. goes to all of our employees, additional 30,000 visits for We provide perinatal services now at 175. Three who have other services such as nursing, to more than a quarter of the been here since the beginning education, counseling, women who delivered at the and 23 who have been here for nutrition, and substance abuse, county hospital. In 1991, this more than 10 years. Not was more.than 1,500 women, enough can be said about all We are a non-profit Community the hard ' work of our Health Center. Our annual Our Homeless program employees. budget is over 8 million dollars continues to expand. We are with slightly over 2 million the agency responsible for all A thank you for the tremendous coming fromm State and Federal primary care at the Home ess support we receive from private grants and contracts. The Shelter (which opened in 1991) providers and public agencies remainder is derived from and in Kern County. thoughout our service area. We patient revenue including now enjoy local political private insurance, Medi-Cal, We are pleased to have support beyond even our Medicare and payment direct received a gracJe of "A" for the wildest imagination. We are from patients on our "sliding last three years, a first and very proud of and appreciative - fee"scale, unmatched in Region IX, of this suppport. PubliC Health Service. Three of our sites, in and around metropolitan Clinica is a consumer driven The success of Clinica Sierra Bakersfield provide services to organization. Originally Vista far exceeds the original predominately Iow income founded by consumers, we projections and expectations of patients. Some. may have a continue to be governed by the funding agencies and third party payor such as patients who bring awareness founders who were involved in Medi-Cal or private insurance, of local needs into the strategic the initial planning phase for a most do not. We see' large planning process. The Board rural health service program in numbers of migrant and has been receptive to new 1970-71. seasonally employed ideas, has changed direction farm-workers.-Our other three and philosophy ~n conjuction sites, two in the mountains, with the changing health care and one in the desert, also environment and has been- ~, · ,,~ / ,_ . provide services to the willing to take risks in order to ' ' "underserved". We are there remain in a strong, competitive because we are the only position. The Board's policies Stephen W.'S provider of medical services to are the goals of assuring these communities, adequate, accessible and Executive Director affordable high-quality care Our staff now includes General services that meet the needs of .............. Practitioners, Family all area residents. Practitioners, Pediatricians, Surgeons, Internists, OB-GYN, 'There are many people to Cardiologists, Podiatrists, and thank for our success over the · Ophtalmologists as well as a last 20 years. First we would Family Practitioner from our UC' like to pay tribute to the people Irvine Residency rotation and who really deserve the most an Internist from our Kern credit, the patients, who place Medical Center rotation, their trust in us. The pregnant LooKing Bac~r 20 Years .... 1971 The original clinic 1976 The Women, grant award to initiate was named Clinica De Los Infants, and Children dental services. Campesinos, a California (WIC) NutritionProgram, non-profit Corporation. It and the Maternal Child 1977~ A commercial loan began with one physician Outreach Program was secured and in atrailerin alocal park. (MCOP) were added to construction began and reinforce our clinics was completed on a 1972 The program preventive health services, modern dental facility. moved to more spacious A computer was also quarters in a nearby installed that year to 1978 Our first satellite storefront building In handle the billing, payroll, clinic, the Frazier Mountain Weedpatch. and payables, and to Community Health Center, gather the data that we are opened and provided the !973 - A number of staff required to report to our community of Frazier Park changes. Planning begins federal and state funding and Lebec with its only for a new facility, sources. Later that year, full-time medical care. This we received a special particular area is unique in 197~,-Ground breaking that it is a solo provider clinic for the entire service area and there are no hospitals in the immediate vicinity. The physician practicing at this satellite is truly the "hometown doc". This year also saw the expansion of our computer system to provide additional data capabilities (IBM System 34). 1979 - Due to the'rapid growth of our program, Clinica Sierra Vista CLINICA SIERRA VISTA - LAMONT constructed an additional 5,000 sq.. ft. of Medical, WIC, and Accounting held for the new facility.to space for the Lamont be built on Hall Road in Lamont. facility. 1975 - After considerable planning, a permanent and modern new facility was constructed and the corporate name was changed to Clinica Sierra Vista, Inc. Also that year our immediate service area (Lamont/Arvin) was designated as a Health Manpower Shortage Area (HMSA), which made this area eligible to receive physician staff' from the National Health Service '~'~'~"~'~",~,~"~'~,~,,~ ...... " Corps. (NHSC). ' FRAZlER MOUNTAIN COMMUNITY HEALTH CENTER 1980 We initiated our adolescent Information and Education Program, and began to work on establishing a satellite clinic in the Kern River Valley. 1981 - Clinica Sierra Vista's Lamont service areas became designated asa Dental Health Manpower Shortage Area, which allowed us to recruit dentists from the National Health Service Corps. 1982 - Our second satellite KERN RIVER HEALTH CENTER clinic, the Kern River Health Center, was opened in July !983 - Work began on the 1985 Permanent federal in the town of Kernville. establishment of a third funding was secured for the This clinic was the satellite clinic in East Baker Street Community culmination of work by Bakersfield. This program Clinic. This' year saw the hundreds of local area was funded by federal next expansion of our EDP residents and Clinica Sierra monies (Job Bill) targeted System to an IBM System Vista, and brought medical to aid the unemployed by 38, a most potent and services to a very providing Iow cost medical sophisticated design which underserved area. Our services, allowed for on-line Lamont Child Care Center capabilities at all of our sites. was also constructed this 1984 - The Baker Street In 1985, we were asked by year with funds donated by Community Clinic opened the Federal government to a private foundation. This its doors to the residents assume a major part.of the center provides care' for of southeast Bakersfield. financial responsibility for young children While their the operation of another parents or siblings visit the clinic, the Toiyabe Indian doctor or dentist. Health Project, which operates three facilities in Inyo County (Bishop, Lone Pine, Camp Antelope). We are providing management oversight and are monitoring the operation. The Toiyabe Indian Health Project serves many Native Americans who reside in the Owens Valley area of California, as well as other moderate income rural residents. Also in 1985, the Death Valley Health Center separated from its previous sponsoring organization and sought us out for linkage and assistance. Clinica Sierra Vista officially became the grantee EAST BAKERSFIELD COMMUNITY HEALTH CENTER and operator of this we were approached by the the demands for primary isolated rural site, located community and State to care services from the in the town of Shoshone, provide primary medical 'area. The WlC program Inyo County. The project services. The Mc Farland was expanded from 4,200 serves a vast area Community Health Center was to 8,000 food vouchers per encompassing all of the granted "intermitenr' status month which are given to Death Valley National permitting the facility to be the eligiblewomen, infants, Monument and southern opened one day per week, and children in our service Inyo County. Patients travel after securing public/corporate areas. as far as 100 miles to seek donations and State funding. primary care at the clinic. 1986 This year we finalized plans for the Kern River Health Center's new facility in Wofford Heights, and began the remodeling project at the East Bakersfield Community Health Center. County funds were received this year enabling us to expand · our Family Community Counseling Services into the area of parenting and child abuse prevention. 1987 During 1987, the MCFARLAND COMMUNITY HEALTH CENTER East Bakersfield Community Health Center experienced an increase in 1989 - The Kern River Health 1990 - Our counseling the patient population Center, originally located in the program, "Born Free" was resUlting in a substantial KernVille area and operating initiated, offering services to remodeling of the 10,000 out of two modular buildings, . substance abusing pregnant sq. ft. facility so as to moved its operations into a women. The County of accommodate the new 7,000 sq. ft. ,$1.2 million Kern began "outstationing" expanded services and facility, located in Wofford .of Medi-Cal Eligibility programs. This year also Heights. The new facility now Workers at our clinics. saw the receiving of federal accommodates increased funds to provide pdmary exam rooms, labortorY, x-ray, 1991 - Our WlC program care services to the and a large conference room expanded again, now · issuing 9,000 vouchers per homeless population of available to community groups-, month. The Lamont clinic. Kern County. for use. During this year, two of began its remodeling our sites were designated activities. This year, our 1988 The McFarland Rural Health Clinics (Lamont Homeless P¢ogram moved Community Health Center and the Kern. River Health its services into the new became our fifth satellite Center). This designation Bakersfield Homeless clinic. With increased provides for a higher Center which opened in media focus on the "cancer reimbursement from Medicare August. We also began cluster" in McFarland, a and Medi-Cal. The McFarland providing Podiatry services side-effect was also the Community Health Center's on Saturdays in Lamont. illumination of the lack in operating hours expanded to Three of our satellites were accessible health care three days per week in order to granted FQHC status. services to the community, accomOdate ............... As a result of this attention, Let's Look At Some Numbers .... Sources of Income 1975-t978 Sources of Income 1979-1982 Soumes of Income Sources of Income ! c.~.3.1986 1987-1990 Title 20 (1.3%) T/tie 20 (1.1%) Pvt. Pay(,9.9%) ~ ] , FederalFunds(40.1%) Pvt. Pay(,5.7%) ~ ~ "~i~~l~ Insurance (12.1%) -~ Insurance (9.~/o) ~ ~~ __~ Meal. care (12.1%) ~ Medicare State Funds (13.1% ) ~'~'"°"~' "_ft' ~.,-u,,,o.~ ~c~,,.,~, * Jt · Local Funds Other Funds (2.6%) Local Funds (.2%) Off'mr Funds (3.3%) Operating Budget 1977-1990 1990 1985' 1984' -- 1982' -- 1978 , 1977 ~ma :.' Patient Visits 1975- 1991 1981' 198o- 197~ ~ 0 20,000 4o, ooo 60,000 ao,'ooo ~ob, ooo ~2b, ooo z4d, ooo ~60,000 Patient wsi~, Patient Ethnicity 1990 Asian (.6~r)~ American Indian (.5%) ~. i F Other (.6%) White (46.6%) ~-- aiack (2.a%) DEATH VALLEY HEALTH CENTER C mmunity Health Centers .... WHAT IS A COMMUNITY ailments or we will refer you fees. Our fees are 'competitive' HEALTH CENTER? to a specialist, e.g., for the area. dermatologist, cardiologist, A community health center, oncologist,etc. A common misconception is (CHC) is a partially federal that a CHC is a 'free' clinic. and/or state funded health A CHC is governed by '.a This is' not true. We are center set up in an Board of Directors. Members 'non-profit'. We barely make "underserved" area to offer are consumers, i.e., they are ends meet each year. If we "primarY care" to its health center patients, or have a little extra money at the patients. The area can be non-consumers. In the case end of the year, we will buy underserved in two ways: of Clinica, we have two new equipment or upgrade our (1) no or few medical consumer members from facilities. We do provide free providers for the area, or each of our health centers, medical and dental services at (2) economics. Patients are The non-consumers include our clinics, as well as the Bakersfield Homeless Center Iow income, I'ack insurance, an R.N., a physician, a Cai with federal grant money and or have Medi-Cal or State University professor, some local support to the Medicare. The area could . 'and a small businessman, homeless population of have, and most likely does, Bakersfield. have a combination of. both. "Kern Clinic wins third straight annual 'A' from U.S. agency..." That was the headline in the Bakersfield Californian in April 1991 after we received our third straight "A". This rating was given Clinic Sierra Vista by the Public Health Service of the Department of Health & Human Services. More than 600 CHC's throughout the nation are evaluated annually based on BAKERSFIELD HOMELESS CENTER performance standards for governance, clinical quality, There are approximately Clinica has an $8 milion scope of program, 600 partially Federal funded budget with approximately administration, and overall CHC's (Section 330 $2 million coming from state 'operational efficiency. This Community Health Center and federal grants and puts Clinica in the top 10% of Act) in the United States. contracts. We accept all CHC's in the country. We private insurance, Medi-Cal, are the only "3-time A" There are 84 in California. A Medicare, and every one recipient in Region IX, which CHC for the most part offers else, i.e., no other "3rd. covers most of the Western "primary care". We do have party" payor, is put on our 'United States. certain "specialtists" on "sliding fee scale". staff, e.g., OB/GYN, Depending on the number Pediatrics, and Internists. in your family and yOur When you come to us with a monthly income, a sliding medical problem, we ..will fee patient will pay from diagnose and treat most 25% to 100% of our normal C!lnica**s ~/ide Range oY ?/lecYicai. Dental. =nc~ Special Services... Patients that require x-ray/ultrasound department, ~eciicat Care specialized diagnosis and as well as a state licensed treatment not available at the Laboratory. Besides Family The Medical staff provides clinic are referred to Practitioners, our provider comprehensive care on an specialists in the local area. staff includes specialists ongoing basis for our patients. We believe that r good health care requires. their participation. At each clinic visit, v~e take time to discuss health concerns. Our medical services include: Diagnosis, treatment, and follow-up of diseases and injuries. - Chronic disease management - Immunizations. - Specialists in child and adult medicine. - Family planning and contra- ception. Pre-and Postnatal service. -'OB/GYN services. Alcohol counseling. VD diagnosis and treatment. Medications prescribed at in obstetrics and gynecology, - Employee programs to pro- the clinic can be obtained at pediatrics, internal, medicine, mote physical and 'psycho- logical well being., our own Pharmacy in infectious diseases, surgery, Podiatry Lamont, or "pre-packaged" opthalmology and podiatry. at satellite clinics. The clinic Opthalmology also operates an Dental Care The dental team at' Clinica Sierra Vista wants to help our patients to have a healthy mouth without experiencing pain or spending a lot of .. money. Most tooth and gum problems can be avoided completely. The secret is coming in for checkups before problems develop. We recommend children visit the dentists at the age of 3 to 4 in order to begin receiving regular flouride treatments to prevent tooth decay, and adults should plan dental checkups every six months to one year. During a checkup, the Maternal Child Outreach' Nutrition ,dental team will clean the Program (MCOP) staff, teeth, give .the patient a nutritionists, counselors, WlC (Women, Infants, and "tour" of the mouth, and and the patient. Classes Children) is a nutrition discuss what 'needs to be are an important part of program for women who are done and why. each prenatal visit they pregnant or breastfeeding, make to the clinic. They and for infants and children Dental services.include: deal with such important up to age 5. WIC offers issues as: classes and counseling on - Cleaning. proper nutrition, and o Oral checkup and What' to expect before, provides food coupons to instruction, during and after childbirth, be used to obtain nutritious Flouride treatment. Nutrition during pregnancY foods free of charge from a Fillings, dentures, crowns, and nursing, grocery store. These foods bridges. Breathing and exercises, contain the proteins, Children's dentistry. Infant care and safety, vitamins, and minerals that Simple oral surgery. Child development, are especially important for Root canal work. Family planning, pregnant women and growing children. To be  ,,....,;,,,~ ,,. ~ ~ .... eligible for WIC. women and i :=::.,~::,- children at nutritional or ,~~-~ \ '~i ~i,! mediCal risk must also meet ~¢~:' certain income and family size requirements. Individual counseling with a Registered Dietician is available to clinic patients who are overweight, · underweight, .anemic, diabetic, have a problem with high blood pressure or high cholesterol. Well-Child Care Well-child care includes attending to a child's physical and ·emotional :,'~r:atai Care needs at home, in addition The prenatal staff believes Evening classes are also to regular visits to the clinic that education, and medical offered. Mothers are for checkups and care can help families 'encouraged to bring a immunizations against prepare for a healthy and partner-so that the two childhood diseases. happy "birth day". Since individuals can learn to Immunizations require a mothers and babies both work together during series of visits and should benefit from early care, they labor and delivery, begin at 2 months. An should come to the clinic as immunization clinic is held soon as they think they are The prenatal staff will visit every Friday afternoon. pregnant, the patient at the hospital For children 1 year of age or and then at home. We under, a PHN or Community As a prenatal patient, they look forward to seeing Health Worker may make a are part of a team. The them at the clinic for their home visit to' assess' the members include the postpartum checkup and child's health and doctor, .nursing personnel, the baby's well-child care. development, and further home 'visits can be arranged whenever the mother feels that evaluation and guidance would be helpful to the patient. Anytime the child becomes ill, the mother may call the clinic and ask to speak to a nurse. The nurse will be able to give their professionalguidance in determining when a child should be seen by the doctor. The Information and Education Project is primarily an outreach We try to present a broad the health care team. To education Project. We have scope of FLE topics ensure the most personal been funded by the State of designed to increase and comprehensive care, California, Office of Family adolescent skills and they want to get to know the Planning to provide Family knowledge, patient and their family. Life Education (FLE) to They offer information ' and adolescents in Kern County ~amiiv Planning referrals for work and since 1980. We. serve more financial problems, and can than 4,000 teens each year. Family planning means help them deal with other Each year we train a team deciding whether or not you social service .agencies. of teen Peer Educators to want to have children, and if They can follow-up on assist us in our so, when. Clinic staff can medical visits at the clinic by presentations. We will work discuss with you the offering health education ~n any setting where invited, different methods of .birth and counseling during but primarily serve in the control in order to assist you home visits. As patient high schools. Our series run in making a choice that is advocates, they can handle from three to twelve best suited to your individual any questions and presentations depending on needs, complaints about the clinic. the individual' setting. We The Community Health teach communication skills, Family planning services are. Workers also work in the decision making skills, self free to many patients, and community, to make esteem and other topics are available to men and residents aware of clinic which promote healthy women of all ages. There services and' to make the choices. In addition to are also special family clinic aware of people's schools, we present planning classes for teens., needs. regularly for all the adolescent residential Social Services facilities run bythe Kern County Juvenile Probation The' Community Health Department. 'In 'this setting Workers are key people on we are allowed to ~, implement and present our' own agenda of FLE topics. Counseling · The Family and Community ' Counseling Service (FCCS) program offers clinical ' counseling services for patients, and. counseling as ' 'part of the Comprehensive Perinatal Services Program ' (CPSP). A program for families with a history of child ' abuse (CAPIT) is offered and includes a series of parenting ' classes for court-referred parents, individual counseling ' sessions, and follow-up for one year. The counseling program is .._~? providing leadership, along · with Information and ' Education staff, for "Born Free", a program for ' substance abusing pregnant women (OCAP). This ' prog. ram includes counseling serwces, prevention oriented ' classes in area high schools, and a Mentor Mommy ' program. The Future .... per week in 1988 using Kern County donations and later state Consortium We have enjoyed significant funding. It still operates out of We are the fiscal agent for the growth over the preceding a 1,000 square foot' house California State Office of AIDS twenty years, working always leased to us for $1 per year byallocation of funds to Kern to meet the challenges of the School District. The clinicCounty. We expect to see increased demand for our sees 25 to 30 patients per expanded 'services in this services at a time of day, mostly children, area. One of our Internists is constricted financial support, one of only two in the County enlarged accountability, and When stable funding can be specializing in infectious continued investment. We are obtained, two things will Diseases. sure this will not change as wehappen: celebrate our Twentieth Adult Day Health Care Anniversary. .- The clinic will become Clinica, in conjunction with the - full-time (5 days per week) Kern County Office on Aging, As we enter our third decade and will include expanded is in the process of developing of patient service, we plan toperinatal services, an Adult Day Health Care continue to work to build a We will move to a larger Facility in the Kern County system of care that will assure facility, area. We have been the survival of a designated by the county as loCally-governed and East Bakersfield Community the Organizational Provider of controlled health care agency. Health Center ADHC services and we are Profitability, not community This is one site where we do now in the planning stages of need, often determines .the not own the building. It is acquiring licensure, facility continued existance of a given located in the area where we location and acquisition, service. That is often a tragicneed to be. The owner of the securing of funds, and mistake.. Through the building has changed a development of proposed formation of consortium and number of times since we services. " affilitation with our health care opened in 1984. Sometime in peers, (other rural providers, the next few years we will buy ........ . clinics, hosPitals, public health the building, move to another departments, etc.) our local facility in the area or buy a lot health care system can be and build. preserved and strengthend as we work and plan in the Death ValleyHealth Center mutual interest of the We have been in trailers since communities we serve, the site became part of Clinica in 1985. In 1992 we will What are we looking at in the complete the remodeling of a future.., building and will move into a new, modern facility. McFarland Community Health Center - The Dental ., community approached us to We have operatories for our 3 open this center when it dentists. As part of our became apparent that lack of ,remodeling project in. Lamont access to primary health care ~n 1992, we will add an was. a prOblem. This operatory and will then be heightened awareness was as able to add a fourth dentist. a result of increased media focus on the "cancer cluster~' Opthalmology in McFarland, 13 cases of A part-time Opthalmologistwill childhood cancer with 6 join our staff in 1992, offering deaths, services on Saturdays at the clinic in Lamont. The site was opened one day Boara .,'vlemi3ers Providers E~(ecutive Staff Shirley Dawson George Laven, MD Stephen W. Schilling Leonard Cherry Shankar Raman, MD Executive Director Juanita Benavidez Margaret Peterson, MD Merced Natera Kelly Mah, MD George Laven, MD Mary Helen Sotelo John Dean, DO Medical Director Theodora Scrivner Lawrence Garcia, MD Luis Rey Hernandez Antonio Garcia, MD Simon Yanez, DDS Abel Gaeta Ruth Embree, MD Dental Director Guadalupe Jimenez Jacqueline Paul, MD Rosendo Gonzales Randall Rouse, MD George Johnston Warren Paap, PhD. Ray Wiser, MD AsSistant Director/ Adolph Schwartz, M.D. Nancy Boyd, MD Operations and Personnel Rita Martinez Carlo 'Amazona, MD Ethel Pat Ricks Denis Maddox, MD Consuelo Cantu Dorothy Stapp Lee Marek, DPM Assistant Director/ Socorro Munoz Simon Yanez; DDS Business Manager Rev. Larry Barton Joel .Napoles,. DDS Virginia Bridges Scott Davis, DDS Linda LOw Wen-Whey Chang, DDS Assistant Director/ Health Leland Perry, DDS Education Services David Riel, FNP Staff with Ten Years Yvonne Greenleaf, FNP Colleen Sullivan Lani Day, FNP Administrative Assistant Lynn Newhouse, PA Manuel Mendez 1971 Paul Gilardone, PA Leticia Galvan Margaret Govea 1971 Bruce Taylor, PA Administrative Assistant Consuelo Cantu 1971 Terry Weno, PA Pedro Gutierrez 1971 .Tom Miller, PA Mary Garcia Gloria Martinez 1971 Administrative Assistant Ruthie Moore 1972 Gloria Rodriguez 1973 Stephen Schilling 1973 Ruben Burciaga 1973 ................ Mary Garcia 1974 Lani Day 1974 Elmer Maim 1975 Bonnie Cruz 1975 Lupe Jacquez 1976 Yvonne Navarro 1976 ~. Irma Cortez 1978 Stan Sherrill 1978 Mary Villalvazo 1978 Gayle Sandoval 1979 Dora Perez 1979 Pauli Mettler 1979 Cristina Guerra 1981 Diana Sherrill 1981 ' ~x St E RRx/ ~ ' u~ PO Box 457 1 8787 Hall Road Lamont, California 93241 (805) 845-3731