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Economic Ills Boost Clinic Caseloads : Medicine: Last year, 4,231 patients visited the county's Ojai health facility. This year, that figure is expected to increase to 12,000.

September 15, 1993|DWAYNE BRAY | TIMES STAFF WRITER

Hospitals and clinics in Ventura County that provide care to low-income patients--including people with jobs but no health benefits--are experiencing record high levels of business.

And health officials see that as a sign of how the recent economic slump has taken away many of the health-care options of the county's poor.

Faced with the loss of a job or just a loss of medical benefits, many patients have been forced to drop their regular private-practice doctors and instead seek medical service from facilities that will serve them without any insurance reimbursement or through Medi-Cal, health authorities said.

One of the most dramatic examples of this trend is the explosive growth of the Oxnard-based primary health-care group Clinicas del Camino Real, a network of four clinics in the county that specializes in care for migrant farm workers and other low-income people.

Patient visits at Clinicas' offices jumped from 35,000 in 1991 to 60,000 in the 1992 fiscal year, officials there said.

Clinicas' Ojai facility, which just opened 14 months ago, is already so busy that it plans to move from its current 1,100-square-foot office to an 8,000-square-foot building next to Ojai Valley Community Hospital in late October.

But Clinicas del Camino Real is not alone in its dramatic growth. Officials at the Ventura County Medical Center, which handles 82% of all the Medi-Cal cases in the county, say patient visits to the medical center and its satellite clinics are also brisker than normal.

What's more shocking, said Pierre Durand, administrator of the county medical center, is the crush of employed workers without medical benefits who are showing up at the county's health and medical facilities.

"But we have been very fortunate in that we have not had to turn people away in this county," Durand said.

Phillip K. Wessels, the county's Health Care Agency director, noted that the increase in patients does not necessarily mean profits for agencies that handle a disproportionate amount of the health services to the uninsured.

"We're struggling," Wessels said of the county medical system, "but we have no shortage of patients."

Clinicas, which started with one location in a strip mall in 1971, has not had a problem attracting patients, either. It now has offices in Oxnard, Saticoy, Fillmore and Ojai, where everything from prenatal care to psychological and dental services are offered.

One of the main attractions to Clinicas for the uninsured is that the clinics have a "sliding-fee scale," which can lower the cost of a typical $39 medical bill to $9 for people whose income falls below the federal poverty line.

Like the county medical center, the clinics do not turn anyone away. The accept-all-comers policy has been costly, administrators say, but well worth it since health care for everyone is part of the clinics' motto.

Jack Hinojosa, associate director of the nonprofit clinics, said Clinicas' four facilities now dole out about $40,000 in uncompensated care each month to the uninsured.

Before the economic recession of the past few years, he said, the clinics were providing only about $10,000 in such care each month.

Clinicas' office in Ojai, called the Ojai Community Health Center, had 4,231 patient visits last year. Roberto Rojas, manager at the Ojai clinic, estimated that number of patient visits will reach about 12,000 once the relocation and expansion is completed in October.

If so, that would bring business at the Ojai clinic more in line with that of Clinicas' three other facilities, which each averaged more than 13,000 patients visits during the fiscal year 1992.

Not everyone visits the clinics because they want a bargain, though.

The staffs at all four of the Clinicas offices are also bilingual, which makes many of their Latino clients more at ease, staff and patients say.

Lilia Barragan, 25, said she started going to the Ojai Community Health Center for that reason, after the place was recommended to her by her sister-in-law.

Barragan brought her 4-month-old daughter, Stacy, to the office for a check-up and immunization shots one recent afternoon.

"This is a nice place," the young mother said. "It has good doctors too."

One of those physicians is Patrick Jolin, 30, who provides care to patients at the Ojai and Oxnard offices. Although Barragan speaks rather fluent English, he communicated with her in Spanish.

"I just enjoy working with Mexican patients," said Jolin, who said about 90% of his patients at the Oxnard clinic are Latino, as are 50% of them at the Ojai facility. "It's a real challenge to practice medicine and learn a new language."

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