Clinic in Crisis

La Familia Medical Center’s chief development officer explains cash shortfall, plan for recovery

After 52 years as a primary care provider in Santa Fe, La Familia Medical Center is in danger of ceasing operations.

According to a letter mailed to supporters this month and an online fundraiser that had brought in $31,934 as of press time, the medical center has about 90 days of operating funds on hand.

The organization, the letter reads, has “operated at a financial deficit since 2013″ and needs $1 million within six months to continue providing patients with low-cost or free medical care. “Santa Fe and La Familia are family,” it continues, “and you know how families are…they have problems, and right now La Familia has problems, and you can help.”

The public plea follows a string of recent events including: administrators fired longtime Dr. Wendy Johnson last July; providers formed a labor union in September and a CEO shakeup followed; then, employees were hit with layoffs and pay cuts announced Oct. 12.

Even though Presbyterian Medical Services recently expanded its clinic, a closure at La Familia would leave few options for some patients. SFR met with Jasmin Milz, La Familia’s chief development officer since 2020.

The interview has been edited for length and clarity.

How did the medical center end up in this situation?

La Familia has been in a funding deficit for years; it’s just the way the model has worked.Part of it is the way in which we see patients—we have a high no-show rate for patients, we have a high number of uninsured patients—and then there is what we call the ARPA [American Rescue Plan Act] cliff. We got funding for a year and a half to help with the influx of all of the [COVID-19] expenses, but that funding ended. Now, it’s going back to that original revenue model we had. It’s almost like a perfect storm.

How has La Familia worked through budget deficits previously, and what are you doing to address it now?

We’ve already had to cut $2 million out of our budget [this year], including 17 positions cut. We cut contracts—basically, everyone here is going to take either a 10% pay cut or take a reduction in hours for everyone who makes over $20 an hour…We’ve done a lot of internal things that are now saving us about $150,000 a month.

In 2009, they did similar cuts. La Familia has had a couple of times…where they’ve had to tighten their belts. This is the last time we intend on doing it. We have a recovery plan that goes into everything that we want to change. We’ve gone back to accepting same-day appointments and walk-ins, so we can fill those gaps when a patient does not show up. We’re looking at getting certified coders to make sure all of our billing is accurate. We’re increasing our hours, we’re looking at making sure we’re seeing enough patients every single day because it’s also about access.

If La Familia were to close, how many patients would lose low-cost or free medical services? How would this affect the Santa Fe community?

It would be a major problem because last year we saw 15,652 patients. That’s one out of every 10 people in the county. Really, if you consider the fact that 77% of our patients either have Medicaid or are uninsured, that has a tremendous impact on the community...There would be a big gap left in this community in regards to health care. If people with insurance are having trouble finding health care, what does that mean for the people who don’t have insurance?

What have conditions been like for La Familia staff for the past few years?

The pandemic’s been very difficult…There’s been a hiring freeze, and the only positions we’re currently hiring are medical, dental and behavioral health providers. For short-term doctor contracts, it’s been very difficult to get providers here. Since we had a number of providers who not only left, but also went out on maternity leave, we decided to bring in short-term [doctors] to help us bridge that gap. What we were trying to do is not impact our immediate care.

A few months ago, La Familia’s 19 physicians, dentists, nurse practitioners and midwives became a bargaining unit represented by the Union of American Physicians and Dentists. What do you expect will be the effect of this change?

We value and welcome our providers making that choice, and will negotiate in complete and total good faith, because all we want is the best for our patients. We’re in support of the union, and obviously we’re going to work collaboratively with them. There’s been a real switch in the whole feeling here.

Shortly after the union vote, La Familia dismissed former CEO Julia Wright. Can you supply any details?

It’s an HR issue. The board recognized that a change in leadership was needed.

Has the clinic’s public image taken a hit?

Maybe the gild has been tarnished a little bit, but I think people recognize our 52-year history in this community, and that we have been the safety net provider for so many. We will get through this.

You’ve been raising money since Oct. 18 on GoFundMe. Is there other money that has come in toward your shortfall, and do you anticipate that the $1 million goal will be met?

That $1 million won’t just be through GoFundMe. It’s state foundations, individual contributions, everything combined. Right now, we’re over $32,000, and that’s just within the last couple of days. It’s really a six-month campaign. The way the fundraising works is, you get your immediate influx from individual donors and the community. Foundation and dollars usually take a little longer to get, and toward the end is when you get state and government funding, because that takes so much longer in the pipeline. We’ll be very close to [the goal]. I expect that we will. This community is so generous and really cares about the organization.

How has La Familia been preparing for a potential closure? What would happen next?

We always have Plan A, Plan B and Plan C. We’re focusing on Plan A because we don’t want to close. Every single person here is working toward that goal. That’s why we went public; we feel that transparency is the most important thing. Our goal is not to close. We’ve told our patients we’re dealing with financial difficulty. We know the community is going to come through.

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