California: One Year Later, Lyon-Martin Still Open

One year after Lyon-Martin Health Services almost closed due to debts, the San Francisco agency has improved its financial outlook. With its tentative budget of $2.4 million, LMHS offers primary medical care and mental health services for low-income and uninsured women and transgender people, including patients with HIV.

Around June, the agency shifted from a hiring freeze and not taking new clients to rehiring staff, accepting new patients, and building the systems needed to endure, said Marj Plumb, LMHS's board chair. Even with its focus on rebuilding, the nonprofit paid off $114,005 in debt last year. Community fundraising helped bring in $600,722.

LMHS's future remains "a complicated question," Plumb said, and it is negotiating with creditors to give the clinic another year. Its total debt is about $1.5 million, including about $550,000 on a loan. "If monthly debt payments are more than we can bring in in a month, in either client fees or clinic fees or fundraising, then we have a problem again," she said. It is "highly possible" LMHS will not pay down much debt this year, but it is current on payments and there is no looming threat, she said.

LMHS's net income for 2011 was $416,050, compared with a loss of $1,466,782 in 2010, most of it written-off bad debts. What was billed for services often was not paid, and the previous board did not fully know that reimbursement was incomplete, Plumb said. As of November 2011, accounts receivable was about $170,000, and officials have not determined how much will be written off.

Last year when the crisis struck, LMHS served about 2,100 patients, and more than half were self-paying an average of $5 per visit. As of November, fewer than half the clients were self-paying, and the clinic was getting an average of $25 per visit. "No one is turned away because they can't pay," said Dr. Dawn Harbatkin, LMHS's interim executive director and medical director.

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