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Posted on www.edgesanfrancisco.com
By Seth Hemmelgarn

Lyon-Martin Health Services, the San Francisco clinic serving women and transgender people that’s been struggling to remain open, is accepting new patients as of today (Thursday, September 1).

The move could mark a turning point for the nonprofit.

In late January, Lyon-Martin’s board made the surprise announcement that the clinic was more than $500,000 in debt and would close within days. Supporters quickly rallied to raise hundreds of thousands of dollars to keep the agency open, but it stopped accepting new enrollees when the board broke the bad news.

In announcing their milestone last week, clinic officials said their agency has stabilized enough to take in new patients.

When asked what had changed to allow Lyon-Martin to begin accepting new clients, interim Executive Director Dr. Dawn Harbatkin said, "It’s about time that we’re taking new patients."

She added, "For Lyon-Martin, typically, 40 percent of our patients each year are new patients. ... We need to continuously bring in new patients" in order to stay open, she said.

She also said she’s excited for Lyon-Martin "to get back to the work that we are good at."

Stacy Pike Long, a Lyon-Martin patient who joined the board in April, said she knows people who have been waiting to go to the clinic, and she’s "thrilled" it is again accepting new patients.

The criteria for new patients appear to be simple. Harbatkin, who is also the clinic’s medical director, said people who want to receive care from the agency need to identify as a woman or as transgender, and they have to be 18 or older. Lyon-Martin doesn’t consider factors such as insurance or lack of insurance, income, or county of residence, she said.

The nonprofit currently has about 2,300 patients. Harbatkin said the clinic’s lost between 300 and 400 patients in the past several months. Some transferred to other clinics, such as patients who were part of Healthy San Francisco, which assists uninsured residents.

In the past several months, clinic officials have talked about changing the payer mix, noting that many patients are uninsured, which makes it harder for Lyon-Martin to bring in the income it needs.

Harbatkin said last week that that mix "hasn’t changed a lot yet."

She said as of May, 77 percent of their patients were still uninsured. The clinic’s working with the San Francisco Health Plan to get new patients, she said. Having people come in through the insurance program brings more Medi-Cal income into the mix, which is "a very good thing for us," Harbatkin explained.

"When we talk about shifting our payer mix," bringing in third-party revenue such as Medi-Cal "is what we’re talking about," she said, since having Medi-Cal patients can help ensure the clinic will get money.

Harbatkin said the clinic would continue to take in people who don’t have insurance. She said the only patients who’ve been asked to transfer to other health care providers are those with Healthy San Francisco.

"I don’t anticipate that happening again," she said.

"If you’re here and you’re in care with us, you’re in care with us, and we are your primary care provider unless you choose to leave ... or you do something outrageous," she said.

In terms of cash flow, Harbatkin said if they had to live on only the money coming in during the next month, the clinic would still have enough to make payroll and pay current expenses for at least two months.

"That’s if no other money came in," she said. "I know that’s not going to happen." She said they’re getting income from "lots of different sources," including contracts, grants, patient services, and fundraising efforts.

The agency has been spending down its reserves. Former interim Executive Director Eric Fimbres said in March that Lyon-Martin had about $100,000 in the bank.

Harbatkin said last week that the last information she saw was that that figure was a little over $50,000. She said the money has gone to bring in new staff and continue operations.

Among other new employees, the clinic has added receptionists, and an additional medical assistant, and "we’ll be bringing on at least one, if not two, more social workers," she said.

The clinic’s total debt remains about $1.1 million, Harbatkin said.