Time and again over the past year, patients at East BostonNeighborhood Health Center have asked Dr. Berestrand Williams, 'Areyou going to be here next year?'
It was a fair question because the center, a mainstay in acommunity isolated from the city, filed for federal bankruptcyprotection in January, facing an estimated $15 million deficit. TheSOS came three months after it finished an expansion of itsfacilities.
At the time, many doubted the financially beleaguered center wouldsurvive. Jack Cradock, the health center's chief executive officer,said he felt like a carnival target duck when he had to respond to aroomful of creditors.
'It seemed like we just came up from under water almost drowning,and then someone would throw a baseball,' Cradock said.
Today, the health center, known for its innovative work,especially in its care for the elderly, is operating in the black. Ithas cut its operating budget from $63 million to $50 million.
But the turnaround has come at a price. To reduce its budget, thehealth center closed its Winthrop clinic, elderly service programs inJamaica Plain and Brighton, an occupational health program, atravelers' clinic at Logan Airport, a home-health service andphysical therapy and podiatry services. It has pared its work forcefrom 1,100 to 759.
Health center officials have proposed a reorganization andfinancial plan. At a court hearing this week, Judge Carol Kennerscheduled a Feb. 1 hearing that could bring the health center out ofbankruptcy, if creditors approve the plan.
Janet Bostwick, the health center's attorney, said a year is'pretty fast for a debtor to come out of reorganization.' Usually, anorganization with the amount of debt that the health center has takesat least 18 months to two years to come out of bankruptcy, Bostwicksaid.
Reversing its past practice of expanding care to satellitecenters, the health center has decided to focus on 'givingspectacular patient care' on the main site on Gove Street, said Dr.James Taylor, the medical director since the center's inception in1970. Taylor also practices at the clinic 3 1/2 days a week.
With the space gained by the 1998 expansion, the health center hasbrought in specialists once housed in Winthrop, brought theobstetrics care into the building from the original center, improvedthe 24-hour urgent care area, and expanded X-ray and laboratoryareas.
What brought the center down, Cradock said, was the expansion ofservices at satellite sites at the time cash flow was hurt byfederal cuts in Medicare and $8 million in disallowed claims from thestate's free-care pool.
Williams said that relying on patchwork funding is difficult,since community health centers, which mainly care for the under- anduninsured, do not have their own reserves when financial disastershappen. 'Society hasn't decided yet if they want to create some kindof funding to care for the uninsured, underinsured and recentemigres. Otherwise, we wouldn't be in bankruptcy,' Williams said.
Escaping the brunt of the cuts are the center's senior citizenprograms, including resident apartments and day programs at threesites within walking distance of the health center. The programsserve 300 seniors who would otherwise qualify for nursing homes, saidDr. James Pedulla, medical director for the elder services.
For John Ribeiro, 60, a probation officer in East Boston who wentto the health center for a physical this week, the East Bostonphysicians and nurses are 'part of our family.'
Financial troubles and an increased patient load have taken a tollon staff, who now must plug away for longer hours and for less payand benefits, said Williams. He has been at the East Boston clinicsince 1987 and was seeing patients until 9 p.m. on a recent night.
Though reducing services such as home care 'ends up hurtingpeople,' Williams lauds the health care workers at East Boston. 'Weprovide state-of-the-art care.'
