Friday, March 28, 2008

County says it won't fund Clinic on Wheels


Community activists clashed with County Public Health Director Elliot Schulman yesterday over how best to utilize a bus nicknamed COW (Clinic on Wheels) that has been idle for more than a year.
The $190,000 bus was purchased in 2006 through a grass roots fundraising effort and donors hoped it would travel to local schools to get uninsured children registered in the healthcare pipeline.

But shortly after the bus hit the road, Rick Feldman, who donated money to help outfit the 37-foot bus, said the program stalled, the bus disappeared and the organization chosen to operate it, American Indian Health & Services, wouldn’t return his phone calls.
Last February, Feldman threatened to file a lawsuit if the bus wasn’t returned and the pink slip handed over. He said this has occurred, but American Indian Health & Services can no longer operate the bus, leaving those who want to see it back in action looking for a place to turn.
Feldman and Deborah Pentland, a nurse for the Santa Barbara School Districts, said they hoped the county could pick up the slack, but were told that wouldn’t be the case.
At yesterday’s meeting, which was held at the Santa Barbara School District’s administration building, and was attended by Schulman, Feldman pointed out the county has one of the highest rates of uninsured children — about 14,000 — in the state, and accused Schulman and the county of thwarting his and Pentland’s efforts to do something about it.
“It’s nonsense to say that our kids are being served adequately,” Feldman said. “I think it’s absurd for the county to provide any barriers.”
Schulman and Peter Hasler, medical director for the County Public Health Department, said they didn’t provide funding for the bus in the past and defended their position to do the same now.
Schulman said there are a number of operational, administration, regulatory and most of all, financial issues with operating the bus.
“I think they want us to operate it,” Schulman said. “That’s not the model we want to use.”
He said the county has long focused on providing healthcare to the county’s uninsured children at its community clinics, of which there are five.
Hasler said the kind of care the bus was registered to provide falls under the state’s Child Health and Disability Prevention Program, which aside from the county’s clinics, is available at several private practices throughout the county.
Simply put, the kind of services Feldman and Pentland hope to provide with the bus are, in Schulman’s opinion, already being handled by the county.
If that’s the case, however, there are still droves of children — as many as 16,000 per month — who Pentland said pass through the Santa Barbara School Districts nurse stations and are badly in need of medical, dental and mental health services.
She said the point of the bus is to give children gateway physicals and at the same time enroll them in Medical.
Schulman said in order to do these things, the bus would need to be staffed and a billing system established — a task the county isn’t fiscally able to take on.
“We are not opposed to the concept of COW,” Schulman said. “It is true there are a lot of uninsured children. We don’t see the COW is the answer to what those problems are.”
American Indian Health & Services Medical Director Dr. Hollanda Leon said the primary reason her organization can no longer operate the bus is money.
“There are a lot of barriers,” she said. “The biggest problem is financial.”
Leon said operating the bus requires five of her fill-time staff and a licensed bus driver. Pile on difficulties with filing paperwork and billing and it’s a big project that doesn’t pay for itself.
While it was clear the two sides had a seemingly irreconcilable difference in opinion about COW, Schulman also told Feldman he didn’t appreciate being invited to a meeting heavily attended by the media.
“I didn’t appreciate this at all,” he said after the meeting to Pentland.
Schulman said he didn’t think the forum was appropriate and neither did Hasler, who could be heard saying he didn’t enjoy the argumentative and confrontational nature of the meeting.
But that aspect didn’t get into full swing until after the meeting, when Schulman and Scott Barash, Pentland’s husband, got into a shouting match inside the boardroom.
Barash said he didn’t think Schulman and the Public Health Department were giving a fair shake to the bus issue. Schulman responded by saying he’s been at the table discussing COW related issues for the past five years.
Barash said he didn’t think it was right for Schulman to show up at a meeting with a confrontational attitude.
Schulman said he thought the meeting in general was confrontational and that sometimes it’s appropriate to be direct.
“Sometimes you need to tell people ‘no that’s not where we’re going,’” he said.


Anonymous said...

the sad thing, is that the COW would
have made it so much easier for kids
to get an exam. It hard to take time
off and take the kid, to a clinic
and then wait a long time.
On the other hand, the county is being impacted by the budget cuts and
cannot take on the COW.
The real losers are the kids.

Greg Knowles said...

I agree with anonymous. Too bad for the kids. Hey Oprah, are you listening? ;o)