BCHF: When Words Don't Match Reality
Last updated 6/16/2022 at 10:02am
Borrego Community Health Foundation (BCHF) took another action, “To protect the long-term access to local care,” announcing layoffs of 218 employees, in addition to the 113 terminated on February 1, 2021. The May 25, 2022 announcement was in the form of a press release from Dan Kramer, BCHF’s public relations consultant.
The layoffs are effective July 24, 2022, and permanent. Unfortunately, in contrast to the optimistic press release, the notice to the employees they were being terminated from the BH Executive Committee, created panic, stating, “Borrego Health is implementing a mass layoff” at twenty sites in San Diego and Riverside. The sites included Borrego Springs’ Administration/Pharmacy/ Dental offices, and Borrego Springs Medical Center.
“Without question, the past 18 months have been significantly challenging for Borrego Health. As we work to navigate our financial and legal issues, we are driven forward by our mission to provide primary care to the underserved,” said Edgar Bulloch, M.D., CEO of Borrego Health.
“Indeed, our patients in Riverside and San Diego counties need Borrego Health. That’s why we’re doing everything we can to overcome our challenges, even though it means making difficult decisions regarding the size of our workforce and our operational structure.”
Something closer to the truth is that Riverside and San Diego Counties need quality health care, especially rural communities, like Borrego Springs, provided by experienced medical professionals. And that’s not the history of Borrego Health.
According to Kramer, the purpose is, “To align with industry benchmark data and best practices from other regional Federally Qualified Health Centers (FQHCs), these initiatives include changes to Borrego’s administrative and clinical teams. It is important to note that the goal of these changes is to ensure Borrego Health’s continued ability to meet the needs of all patients at current clinic locations.
“These initiatives do not involve changes to clinic hours or currently scheduled appointments, nor do they involve physicians or Advanced Practice Providers engaged in direct patient care. As these changes take effect over the next 60 days, Borrego Health will be working to ensure patients continue to have access to the care they need.”
Interpreted, this means the state Department of Health Care Services (DHCS) and monitors are putting the squeeze on the BH Board of Trustees to comply (finally) with FQHC regulations, and legitimate business practices. The bottom line is without these changes the guys in charge at the state and federal levels will yank BH’s license. How the changes protect “long-term access to local care,” as in Borrego Springs, remains to be seen. It also reflects the down turn in funds after losing the state’s Denti-Cal reimbursements, resulting from BH’s alleged fraudulent contract with Premier Healthcare Management. BH was dependent on these private dental contracts for its income, which contributed 40 – 60%, depending on the tax years.
Borrego Health’s privately contracted dental care, and Premier are the focus of the FBI, and California Department of Justice (DOJ) investigations. Both, BH Chairman of the Board of Trustees at the time, Dan Anderson, and Nicolas Priest, of Premier Healthcare Management, claimed the criminal case involved a “Few bad dentists,” or “A single dental clinic,” or a “Few facilities.”
Borrego Health, despite glowing reviews of rapid growth – “The fast growing FQHC center and the most expensive in the Nation,” and “Breath-taking fiscal gains annually” – was actually losing money at a number of clinics. Two Riverside clinics, leasing property from Dan Anderson, past chairman of the BH Board of Trustees, for example, were said to be losing $6 million a year. The “alleged” illicit dental practices had been keeping the foundation, not just a float, but rich. Without the fraudulent practices, BH had real financial issues.
The employee reductions, also, likely, reveal a drop in patients due to the lack of trust and erosion in quality care before, and, getting worse after the investigation in a number of clinics.
When asked what the staffing changes would mean for the Borrego Springs Clinic? Kramer replied, “Three employees were affected.” He would not give specifics of the employees. “It’s important to note that there will be no changes to the level of care at the clinic or its operating hours,” Kramer claimed.
Too bad. Because that’s what the community wanted: Changes to the level of care – improved changes, including longer hours, not less staff or medical programs.
The idea there will be no changes of the level of care at the clinic despite the loss of three employees is a stretch, considering the clinic is always losing doctors and hasn’t been adequately staffed since before the pandemic.
Kramer’s response was, “Based on current patient volumes and provided services, Borrego’s clinic staffing will be reduced to increase care team effectiveness and improve patient care.”
When asked about doctors at the Borrego Springs Clinic? BH reported that Nurse Practitioner Michael Ramos is currently staffing the Clinic, Mondays through Thursdays, with Dr. Jose Hernandez on Fridays. Dr. Brenda Figueroa continues to provide pediatric specialty services two times a month, and Unneetha Pruitt, nurse practitioner, offers women’s health services bi-monthly.
“We are continuing to recruit for a full-time permanent physician in the area,” Kramer noted.
Fears for the pharmacy seem allayed, at least for the time being, with only one employee laid off; and, “No changes in hours or service,” according to Kramer. The Woolcott Dental office remains open – sometimes.
Inside sources said, “X-ray service with 10 employees and 18 phlebotomists laid off, were being discontinued in some clinics.” However, Borrego’s clinic is providing X-rays.
The major layoffs are 70 people in clinic support, followed by 37 in the former Call Center.
About closing down the Call Center, the press release went on to explain that, “It will increase its focus on the patient experience by shifting from a centralized call center to clinic-level customer support.” Sounds good doesn’t it? Hope it works better than the last call system. Meanwhile, losing 70 people in clinic support may, or may not prove advantageous for patients.
The good news is: cuts were finally made in the bloated administrative/officer level, something the Borrego Sun has criticized many times, especially given that salaries ranged from $600,000 to $400,000 plus benefits, triple times or more than their professional peers. The recent cuts were in finance, admin, support, legal, education, human resources, and technology information. Nurses, nursing administration and nursing support were also cut by 28 employees.
Of note, is the fact that even with all those administrators/officers, and let’s not forget managers, the report by DCHS criticized BH for lack of internal cohesion and working toward common goals. In other words, the left hand never knew, or cared, what the right hand was doing.
What is the appropriate staffing at the Borrego Springs Clinic? The types of services and providers needed by the real demographics of residents would draw people in. Providing what the Foundation can afford, first by starving the clinics with health revenues going into the pockets of private individuals; and now, the consequences of greed brought to light and, hopefully, justice, is not the way to really grow the Clinic and serve the community’s medical needs.
The Borrego Cares group, local residents and medical experts with national expertise, advised BH what the community needed at the Clinic. Just as the Chamber of Commerce’s local survey should have alerted the Foundation to how unhappy the community was with the service, the group researched a staff profile for the local clinic that would actually provide quality of care and attract patients. However, BH wasn’t interested.
At the present time, Borrego Cares has proposed to have the Clinic spun from the BH network and administration, serving as an individual community entity, partnering with BH for FQHC status only, and administered by an independent, local board of medical professionals, community members and Clinic patients. This would allow the Clinic to keep its revenue from the state Medical and Denti-Cal programs, as well as federal Medicare and grants, rather than trying to survive on the pittance that BH currently dispenses. Clinics, currently, get their funding after the 26 officers and highest paid professionals.
Under this scenario, the Clinic would be free of the legal entanglements and fiscal crisis facing Borrego Health. Plus, the Clinic could take local donations and grants from the Borrego Valley Endowment Fund (BVEF), which was established for the purpose of supporting a clinic/healthcare in Borrego Springs. All that’s needed is a professional administration, trained staff, and distance from Borrego Health.
Big on the list, are qualified, permanently, settled doctors that people can know and rely on. However, with Borrego Health’s problems and lack of credibility in the medical world, it will take recruiters that know where good doctors, willing to take reasonable salaries for the privilege of living in the desert, can be found and recruited. The chief medical recruiters for Borrego Health – the now deceased, Bruce Hebets, a Harbor Patrol Sergeant, and Dr. Alberto Ratniewski, Hebets’ partner in personal, financial self-aggrandizement schemes, and Mikia Wallis, former CEO, Hebets’ replacement clone, and attorney to Hebets, did not meet the criteria.
Members of the Borrego Cares group do.
By the same token, what qualified, professional dentists would hook up with a contractor, and real estate magnate, like Daryl Priest, owner of Premier Healthcare Management? The only FQHC signed up with Premier was guess who? Borrego Health, headed by Priest’s best buddy, Bruce Hebets. There was a good reason other legitimate FQHC’s did not sign on with Premiere Healthcare.
“To keep a permanent, qualified doctor, the problems at the Clinic and Foundation will have to be resolved,” Dr. Laura Goetz, the most recent doctor to leave the Clinic, stated. She added that, regarding her resignation, she found working conditions “difficult.”
Goetz, like Dr. Carrolee Barlow, former CEO of the Parkinson’s Institute, Borrego homeowner and a member of the Borrego Cares Group, recommended the Clinic doctor should be an internal specialist to better meet the majority of clients’ medical issues. Dr. Goetz, also, suggested the Clinic should stay open until 8 p.m. for working families, and open on Saturday. To date, neither of these recommendations have been implemented by the BH Board of Trustees.
And, the Borrego Springs Clinic is not the exception when it comes to needing doctors. As one clinic manager explained, “With the recent layoffs, things couldn’t get worse for the clinics. BCHF has been struggling with providers leaving for better opportunities, making it nearly impossible for a clinic to operate properly.”
Centro Medico Oasis, in Thermal, is another example of a clinic needing a doctor. With only a part-time family practice doctor on Fridays, it’s complicated to do any follow up visits, as his schedule is booked for the next month. This drives patients away who are seeking an earlier appointment, not to mention, reliable coverage. People’s medication refills, hospital follow ups, and lab follow ups are just some of the barrier’s patients will be facing, if the lack of coverage is not resolved soon.
While long-time board member, and past Board of Trustees’ Chairman, Dan Anderson, is leading the charge into the future behind the scenes, not much will really change. Anderson, as Chairman, supported Mikia Wallis’s unqualified and unprofessional administration and medical leadership as she followed the Hebets’ formula of get rich schemes. Schemes that were breaking regulations and laws from the IRS, federal Department of Health and Human Resources (HHR), and state DHCS oversight of FQHC Centers’ funding. FQHC funding comes from taxpayers, and is meant for trained people to operate clinics that actually fit and services a community’s needs and medical profile, not the promotion of family and friends.
In a Desert Sun interview, Dr. Bulloch talked about the DOJ investigation, stating, “The organization is fully cooperating because we would like to have a quick resolution to this so we can move on and focus on patient care, “ he added that, “We have compliance monitors that are working with us to make sure that we’re…working toward the utmost integrity in everything we do. So, I’m confident that we are moving forward in a positive direction with the (California) Department of Health Care Services.”
Wouldn’t it be satisfying to have a clinic administration that wasn’t facing charges of fraud and other illegal activities; that was professional; knew how to develop and implement a sustainable business plan; secure enough with their expertise, and honest enough to be transparent about their dealings; and, at the same time, able to think outside the box to promote and cater to Borrego Springs’ specific medical concerns. Fresh ideas, like a Patient Advisory Board, would go a long way in promoting a new beginning and regaining community trust.
That’s not a fantasy. It’s a real possibility with the Borrego Cares’ agenda and charter. The only thing needed is for the Board of Trustees to do the same deal with Borrego Cares that Dan Anderson gave himself – a partnership with Borrego Health, limited to sharing FQHC status, with a clinic operated independently by the local community, rather than the victim of the train wreck that is the Borrego Health Community Foundation.
Note: To add insult to injury, BH is opening a new clinic in the City of Coachella in July. About the project, which Dr. Bulloch said has been in the works for years, he stated… “We will be increasing access to much needed care, high quality health care to the people of Coachella.”
Good luck Coachella, folks in Borrego Springs have heard those empty promises before.