Primary caregiver. (People).Armed with an increase in funding, Los Angeles Los Angeles (lôs ăn`jələs, lŏs, ăn`jəlēz'), city (1990 pop. 3,485,398), seat of Los Angeles co., S Calif.; inc. 1850. Free Clinic head Joseph Dunn does battle in the front lines of the county's troubled health system WITH cash-strapped Los Angeles County closing its own clinics and cutting funding for private community clinics, it's a precarious time for local health care. But the Los Angeles Free Clinic is expanding. This year, it opened its third site, on Melrose Avenue Melrose Avenue is a well-known Los Angeles street that starts from Santa Monica Boulevard at the border between Beverly Hills and West Hollywood and ends at Hoover Street in Silver Lake. Melrose runs north of Beverly Boulevard and south of Santa Monica Boulevard. in Hollywood, after receiving a sizable siz·a·ble also size·a·ble adj. Of considerable size; fairly large. siz  a·ble·ness n. boost in county funding.
Started 35 years ago to serve the "flower children" living on L.A. streets, the Free Clinic provides primary health care to 36,000 uninsured people each year. As the county struggles to keep its facilities open while facing a projected budget deficit that could hit $800 million in 2005, it's a challenging time for Joseph Dunn, the free clinic's executive director since February 2001. Dunn is the former chief executive of the Daniel Freeman Hospitals The Freeman Hospital is an 800-bed tertiary referral centre in Newcastle, England. The hospital is run by the Newcastle upon Tyne NHS Trust and is a teaching hospital for the University of Newcastle upon Tyne medical school. , which were sold last year. Question: The county is closing its clinics and cutting funding for private community clinics. How is the L.A. Free Clinic doing amid this crisis? Answer: We probably doubled our (county) money. We went from about $2 million in county funding to $4 million in county funding. Q: How did you manage that? A: We opened our third site (The Hollywood Wilshire Health Center) on Melrose Avenue in April. Q: So how were you able to open a new clinic this year, while most other clinics are at best staying even? A: The county has not been providing family medicine services in that area near Melrose, and I think where we are located helped. We were the logical choice (to operate it.) Q: Are you doing anything different at the Melrose clinic? A: We have been very dependent on volunteers and residency A duration of stay required by state and local laws that entitles a person to the legal protection and benefits provided by applicable statutes. States have required state residency for a variety of rights, including the right to vote, the right to run for public office, the programs to provide primary care. (At Melrose) we modeled it like a private family medicine clinic. Families are able to come together and see one physician. If you have a medical home, you are able to keep data, evaluate outcomes, look at satisfaction, look at how well diabetes rates go down over time. Q: That's not usually the case? A: No, families who do not have traditional health care coverage--a mom, dad, grandma and grandpa and the kids--they all may be eligible for some type of funding, but it may be such that their health care can't be delivered in the same venue. So you have four people who have to go to four different places, because that is where their funding is. It does not promote good family care. Q: Coming from running a large hospital, what has surprised you about the clinic? A: Free clinics were started as just responses to a community need. People came in and worked together, volunteered and delivered care. Everybody felt good and went home. Now it's a more complex environment. I never dreamed there were so many funding streams. You have to really keep watch on when funding streams end and which ones aren't funded until a certain time of the year, etc. Q: Are these funding sources enough for you to deliver the care that you do? A: You have to depend on strategic partners in the community, like the hospitals. It's to their benefit. They want this population to get services, access to care in a more reasonable way, so they are not tapping into the emergency rooms for services that should be handled in an ambulatory care ambulatory care n. Medical care provided to outpatients. ambulatory care, n the health services provided on an outpatient basis to those who can visit a health care facility and return home the same day. setting. Q: How well do the clinics and hospitals work together? A: They have not worked together the way they should have. There are certainly assessments of community need that we do share but as far as specifics, there isn't a lot of coordination. Q: What about in your case, being only a few blocks from Cedars-Sinai Medical Center Cedars-Sinai Medical Center is a world-renowned hospital located in Los Angeles, California. History Cedars-Sinai is the result of a merger in 1961 between two major Los Angeles hospitals, Cedars of Lebanon and Mount Sinai Home for the Incurables, with Steve Broidy as ? Is the relationship better than average? A: Yes. We provide patients for residents specializing in community health care. They do some of the higher level testing that is needed--CT scans that we don't have, so we can continue to manage our patients in a way that keeps them healthy and out of the ER. It's not just Cedars trying to save money. It's just a reasonable approach to health care. Q: How good is the care that people receive at your clinic? A: I think the care is on par with anything you would get with a private physician. It may take longer perhaps to get appointments, but we do have referrals to specialists. We are able to follow people over time with chronic conditions. I am very proud of the care we give. Q: And what is the typical profile of a patient? A: In general it's the working poor--people who may have a steady job but don't work for an employer who provides health insurance. Or they get laid off, so they have health insurance but they can't afford to keep it up. It's not necessarily people who don't have any money. Q: How do you assess the state of the public health system in general? A: I can't stress enough how fragile the system is. We are lucky we have a great fund-raising board. But other agencies are more fragile and provide wonderful needed services that may or may not be able to survive a gap in funding that lasts a long time. Q: What do you think of the cuts county health director Dr. Thomas Garthwaite has proposed? A: Dr. Garthwaite believes that a system based on outpatient programs is healthier in the long run than a system dependent on inpatient care inpatient care Managed care Services delivered to a Pt who needs physician care for > 24 hrs in a hospital with ambulatory Movable; revocable; subject to change; capable of alteration. An ambulatory court was the former name of the Court of King's Bench in England. It would convene wherever the king who presided over it could be found, moving its location as the king moved. as an afterthought af·ter·thought n. An idea, response, or explanation that occurs to one after an event or decision. afterthought Noun 1. . Some of the changes he is recommending are very fundamental, such as combining expensive services at one hospital and having one neonatal neonatal /neo·na·tal/ (ne?o-nat´'l) pertaining to the first four weeks after birth. ne·o·na·tal adj. Of or relating to the first 28 days of an infant's life. care unit instead of two. That is right on. Q: But the county is closing 11 health centers and cutting $15 million in funding from the private clinics at the same time. A: The closing of the clinics is more of a budgetary issue. There is no other choice than to do something. Q: Do you agree with some critics that the supervisors should just dip into dip into Verb 1. to draw upon: he dipped into his savings 2. to read passages at random from (a book or journal) Verb 1. their $500 million in reserves to try and lessen less·en v. less·ened, less·en·ing, less·ens v.tr. 1. To make less; reduce. 2. Archaic To make little of; belittle. v.intr. To become less; decrease. some of these cuts? A: I don't think the county should dip into the reserves without addressing the much needed changes that everyone agrees needs to happen to make the system better, more accountable and more efficient. It's nice to know the money is there, but I think that changes still have to occur. Q: Have the closing of the county clinics affected your facility? A: It's too early to tell. We (already) had people lining up every morning and we only have so many walk-in appointments. I have heard that the ERs are already feeling it. People are just as likely to go to ERs as they would to clinics. RELATED ARTICLE: INTERVIEW Joseph Dunn Title: Executive director Organization: The Los Angeles Free Clinic Born: Purcell, Okla., 1950 Education: Bachelor in clinical psychology from Oklahoma State University Oklahoma State University, at Stillwater; land-grant and state supported; coeducational; chartered 1890, opened 1891 as Oklahoma Agricultural and Mechanical College, renamed 1957. ; masters and doctorate in clinical psychology from University of Kansas The University of Kansas (often referred to as KU or just Kansas) is an institution of higher learning in Lawrence, Kansas. The main campus resides atop Mount Oread. ; MBA MBA abbr. Master of Business Administration Noun 1. MBA - a master's degree in business Master in Business, Master in Business Administration from Pepperdine University Pepperdine University is a private institution of higher learning affiliated with the Church of Christ in unincorporated Los Angeles County, California, United States. The university's location overlooks the Pacific Ocean and is adjacent to the city limits of Malibu. . Career Turning Point: Taking administrative job at Daniel Freeman Hospitals in 1989. Most Admired Person: Grandmother Personal: Single Hobbies: Traveling, jogging jogging Aerobic exercise involving running at an easy pace. Jogging (1967) by Bill Bowerman and W.E. Harris boosted jogging's popularity for fitness, weight loss, and stress relief. |
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