Viewpoint: Borrego Clinic
Last updated 6/1/2020 at 12:51pm
Americans throughout the country are celebrating and honoring health care workers as warriors during the coronavirus pandemic. In Borrego Springs, they are being terminated.
With the firing of the Borrego Springs clinic’s full time, resident nurse practitioner, mental health therapist, and unexplained absence of the resident medical doctor, the Borrego community has to ask: Is Borrego Health providing adequate health services?
A high percentage of the Borrego population are elderly. Many residents live barely above the poverty line, and some under it, with many depending on seasonal employment. When it comes to being impacted by the virus, or accessing normal health care services, they are an economically vulnerable population. For many, private insurance is a luxury, which is why the Borrego Health Community Foundation qualifies for Medicare and Medicaid and other government subsidized funding to provide for management of serious illnesses and preventative care among the local population. This was before the pandemic. Things are worse now. Even people who once had insurance through their employers, or paid for treatments and prescriptions from their pay checks, are out of luck.
Right now in this valley, more people, not less, will depend on tax-payer subsidized services of the clinic. People who avoid treatment from fear of exposure to the virus, or don’t have access to their health care will become sicker. The stress and anxiety for the future, not to mention practice of isolation, not only compounds suffering for people with emotional and mental health issues, but creates new victims.
This would not be so critical, if like other Borrego Health Clinics, located in urban areas such as Escondido, El Cajon, La Mesa, and San Bernardino, Borregans had easy access to alternative providers. Cities offer private and public health care from free clinics, and doctors to hospitals. But in Borrego, the clinic is the only medical facility and mental health option available within a 70-mile radius.
We’re alone out here. Without our clinic, people who don’t have private transportation, can’t drive, or afford to drive and maybe suffer from diabetes, cancer or heart disease, find themselves in a desperate situation. The community has life and death issues that are not related to the virus. What does it mean when one day the medical professionals who write the prescriptions for you, your child, or grandmother, suddenly disappear? How do you feel when the nurse you trust, and has been managing your health issues for years, is replaced with a stranger on the end of a phone? What then? You may worry. You want to know what’s up? You ask questions. That’s what the Borrego Sun has been doing.
Borrego Springs is at the “what then?” The absence of full-time professionals begs the question of how the community’s health problems being met? We realize we’re in a health and economic crisis caused by the pandemic. All the more reason to expect leadership, transparency, and support from Borrego Health, as the only primary providers available. We not only need to ask questions, but expect answers we can live with.
The termination of Dr. Pam McEvoy and Jan Jones, by all accounts, not only seems callous, but short sighted in the middle of a health crisis. As icons and trusted institutions, they deserved better.
How’s that working? we asked
“Not so well,” according to people, contacting the newspaper.
When the Sun raised questions with the Borrego Health spokesperson, executive administrators and trustees, they weren’t willing to discuss either the present or future prognosis for the clinic’s ability to meet community needs. They weren’t even willing to explain, reassure people with sensible explanations, or prove that people have no reason to worry, let alone how, when, and if, they intend to replace our resident, full-time, licensed professionals. We asked and asked. We called and called. The only responses forthcoming were rigid referrals to an unsigned one- page statement distributed to Borrego organizations, after the Borrego Sun began asking questions.
Every story has at least two sides, usually more. We know there are caring and dedicated health care workers within the Borrego Health Network. We believe we need to give them our praise and a pass, as they bravery perform their duties under challenging obstacles at risk to their own health. We just wanted assurances from people in charge – Borrego Health – that the Leadership Team is up to the task.
We have given Borrego Health, repeated and ample opportunities to share the facts as they see them, talk to us about the problems they are facing during this challenging time; and how they are handling the pandemic’s economic and health impact on service delivery, both here at Borrego and the Foundation’s other 20 facilities.
The Borrego Sun has a history of reporting on concerns about the foundation, its growth, acquisition and merger practices; luxurious non-medical assets, lopsided administration and management positions, many receiving extremely generous salaries, exceeding CEO norms in major medical institutions; and hiring and promoting family members to key, high earning positions, some without appropriate medical credentials or management experience.
So of course, we asked questions. And received no answers to the more than 20 written questions the Borrego Health spokesperson requested the Sun submit.
All we received was the same cookie-cutter, one page statement.
BH Statement: “As a result of the rapidly escalating COVID-19 public health emergency, Borrego Health activated its clinic command center on March 6, and has monitored the situation ever since.”
Borrego Sun Asked: What does monitoring mean – watching, doing, following? Borrego Health does not treat coronavirus patients, so monitoring what? It’s spread, maybe? There are no tests available at the clinic, unless a doctor agrees a patient has the symptoms, and then, a referral onto a hospital. Where is the “command center”? Who’s in charge? and what, specifically, is the command center doing to lessen the impact of treating ongoing community health issues.
Borrego Sun Asked: According to the Borrego Health statement, the “Command Center was activated on March 6.” So why did Borrego Springs patients receive texts from Borrego Health stating, “There is a low chance of getting coronavirus in the U.S. However, it’s good to know the signs” with a referral to the Center for Disease Control website for further information on March 19? Oops, this was three days after the President declared the virus a national emergency.
Borrego Sun Asked: Why did it take a month for a text to arrive stating, “We apologize for the prior message from Borrego Health that there is a low risk of contracting coronavirus in the U.S. The message was incorrect and sent in error.” The correction of the “Incorrect and Erroneous” text sent to Borrego cell phones on April 13. One month after the “not to worry” announcement.
BH Statement: “Over the last eight weeks, across our organization, we have experienced a dramatic shift in the way primary care is delivered. We have increased the capacity for telephone or telehealth visits significantly in an effort to mitigate the risk of exposure to COVID for some of our most vulnerable patient populations.
Borrego Sun Asked: Is firing the experienced full-time, only full-time licensed health workers at Borrego Clinic the best way to protect the most vulnerable patients? Older adults suffering from cancer, heart, diabetes, hypertension, obesity and immune diseases have managed care treatment through the clinic, without their regular ongoing treatment aren’t they doubly vulnerable? Was it appropriate to place their treatments on hold, or transfer them to unknown providers from other clinics?
BH Statement: “At the same time, like other businesses and healthcare providers across the country, Borrego Health has experienced significant financial strain due to the pandemic. As a result, we have had to make the same agonizing business decisions that every health center in America is dealing with in response to major revenue shortfalls. These actions include temporary reductions of hours, reductions of services, or closures at some sites. In addition, nearly a third of our workforce has been impacted by reduced hours, temporary furloughs, or layoffs.”
Borrego Sun Asked: What was the criteria for termination, vs temporary furlough vs salary reductions? Who determined the priorities? Were there different options, equitably applied to all clinics? Were ages, sexes, wages of workers a consideration? Were the unique character and demographics of rural vs urban clinic, applied before closure or staff layoffs? Or were some clinics considered more expendable in terms of employees than others? If so, on what basis? Which clinics are closed and why?
Borrego Sun Asked: Did Borrego Health apply for, or receive a stimulus loan or a Payroll Protection Program loan from the Federal government. If so, how much was received? How was it used?
Borrego Sun Asked: Do the aforementioned layoffs, furloughs and salary reductions apply to administrators and paid executives of Borrego Health Community Foundation and affiliate business ventures? To what extent did the executive level – chiefs, executive chiefs, department heads, etc., also experience a one-third staffing reduction? Please quantify.
BH Statement: “These heartbreaking decisions have been necessary to ensure we can endure the current crisis and remain sustainable in the future. Though, like all of our health clinics, the Borrego Medical Center has been impacted by difficult workforce changes, we are committed to this community and will keep our clinic’s doors proudly open during the COVID-19 crisis, and beyond.
The current hours of operation of the Borrego Medical Center are Monday through Friday, 8 a.m. to 5 p.m. At this time, a licensed medical provider is on site every day. Telehealth and telephone visits are also available.”
Borrego Sun Asked: Please supply the names, titles and expertise of the licensed providers that are on site daily? Please explain how the duties of the absent resident doctor are being covered? Please list current services available at the clinic?
BH Statement: “Though we now find ourselves in an unprecedented time of crisis, Borrego Health is committed to ensuring the healthcare needs of the Borrego Valley are met.”
That’s exactly what the Borrego Sun was looking for: Answers to questions about how Borrego Health is committed to ensuring the healthcare needs of the Borrego Valley are met, presently and in the future. Only, we need facts and specifics.
In this agonizing time of unknowing and uncertainty, Borregans deserve more than a public relations statement filled with empty platitudes and boiler-point catch phrases.
The ball’s in your court Borrego Health