Calif. Health Agency, Housing Authority Open Community Health Center

Feb. 01--The head of Clinica Sierra Vista is always looking for good space for health centers, nice places that its often-struggling patients would want to return to for care.

The head of the Housing Authority of the County of Kern needed a tenant for the bottom floor of its affordable-townhouse/loft complex in Old Town Kern.

They can't remember who called whom first but they decided to partner up, the result being the new Baker Street Village Community Health Center.

It's an example of an agency-agency collaboration that's helping extend healthcare to the growing number of people seeking it as a result of the Affordable Care Act.

It's the first of its kind here, but other examples abound elsewhere.

In Fresno, Clinica helped design and now operates a health clinic on the campus of a junior high school. In Hayward, a clinic recently opened on the grounds of a firehouse.

These kinds of partnerships just make sense, said Clinica's CEO, Steve Schilling.

"Think about schools," he said. "We build these facilities at a huge cost...and we run them from 7:30 a.m. to 2:30 p.m. And then we mothball them for three months in the summer. That's crazy."

'MOVED UP'

The 37-housing-unit Baker Street Village, on Baker between Monterey and Kentucky streets, started out as a mixed condo/retail development that lost financing during the housing crash of 2007-2008.

It sat unfinished for a year and a half. With $13 million in federal stimulus money and city redevelopment funds, the housing authority built affordable lofts and townhouses.

When Baker Street Village opened in 2011, the housing filled up within a week, said authority Executive Director Stephen Pelz. But it couldn't find a desirable commercial tenant.

It was around 2012 that Schilling and Pelz started talking about partnering up. Turned out things were a lot more complicated than "simply bringing the furniture in," as Schilling put it.

Like who pays for the remodeling? The housing authority ended up doing the work but Clinica will pay it back over the life of a 15-year lease. Pivotal assists came from Valley Republic Bank, which approved a $500,000 loan, and the city, which pitched in $200,000.

The 4,000-square-foot, four- exam-room clinic opened in December and is providing primary care to roughly 20 people a day. People can make appointments or just drop in. There's a doctor and nurse practitioner there plus additional staff. Schilling could hire another doctor, but the valley's chronic physician shortage prevents that right now.

The facility and equipment is all brand new; the walls are decorated with scenic canvas prints.

"It's like 'The Jeffersons.' We've moved up from the east side," 65-year-old Clinica patient Larry Williams joked when asked about the new digs.

He's been going to one of Clinica's older facilities for drug and alcohol treatment -- he says he's been "15 months, three weeks" sober -- and now goes to the new one for treatment of heart problems and high-blood pressure.

A Vietnam vet, Williams' homes of late have been The Mission of Kern County and a sober living facility. He couldn't have said nicer things about the quality of health care he's getting, especially the quality of the staff.

"It's like God said, 'Put people down here for the care of my children,'" Williams said.

Married couple Alecia Ruybal, 31, and Walter Gasper, 30, like having a clinic within walking distance of their place near Kern Medical Center, which they moved into last October after two years living on the streets.

Gasper goes to Baker Street Village for thyroid medication, Ruybal for general care. A Clinica case worker also found them their housing and makes sure they take care of their health.

"It's easy for me to get complacent," Gasper said. "She lights a fire under me and keeps it stoked."

One of Schilling's key goals was to develop a place patients would want to return to, saying "If you stick people in a dumpy place, you're never going to achieve the result you want."

He and Pelz also hope the complex will help spruce up the rest of the neighborhood. It already has begun to, Pelz said, with a convenience store and day-care center opening up nearby.

OTHERS TEAM UP

While Clinca just opened up in Baker Street Village, it's well into another partnership -- with the Fresno Unified School District.

It operates a health clinic on the campus of Rutherford B. Gaston Middle School in southwest Fresno, one of 2,315 school-based health centers nationwide, according to a 2013-2014 census conducted and recently released by the School-Based Health Alliance in Washington, D.C.

Open since August 2014, the Fresno clinic was originally designed for students at Gaston, six feeder elementary schools and two feeder high schools, said Ruben Chavez, Clinica's chief administrative officer for Fresno. Clinica eventually opened it up to all kids in the surrounding neighborhood.

"There's a lot of literature about school-based health centers being pretty influential in improving academic success," Chavez said.

"Instead of a student having to leave school for half a day to go to the doctor if he doesn't feel well...the health center can call mom and dad and say, 'Hey, Jimmy doesn't feel good. We're gonna see him. Then maybe they give him medication or whatever and he goes back to class."

In its first year the clinic handled about 4,000 visits. It's open even when school is closed: from 8 a.m. to 5 p.m. daily, during holiday weeks and in the summer.

Fresno Unified would like to develop more of them, Chavez said.

"They really want to improve the status of their students' academic achievement and they've realized this is one way of doing it," he said.

Further north is a health clinic that wouldn't exist were it not for agencies getting together and innovating: The Firehouse Clinic in Hayward, which opened in November.

The facility is what it sounds like: a primary care health center for people of all ages built on the grounds of a new fire station. It's designed to bring health care to where people are and a place they trust.

The city of Hayward built it, the County of Alameda helps finance its operation (for now) and the Tiburcio Vasquez Health Center runs it. Before, there were no primary care facilities in the area for adults, only children, said David Vliet, CEO of Tiburcio Vasquez.

"It's a cost-effective way to create more access (to care) in a place the public perceives as a place of safety," he said.

Vliet would eventually like to see coordination of care between emergency medical personnel and the clinic, like paramedics being able to bring patients to the clinic instead of the emergency room if that's all they need. But that would require a change in state law.

LOOKING FORWARD

Schilling would love to replicate what Clinica and the Kern housing authority have done on Baker Street. Sitting in a meeting room with Pelz and a reporter recently, he started brainstorming out loud.

What about east McFarland? West Delano? North Oildale?

"We need to throw some maps up on the wall," Schilling said.

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