Should Lyon-Martin be saved?

Dumping 3,500 patients into a public health system that has been cut to the bone over the last few years would be a disaster in San Francisco.

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OPINION Last month, when the startling news broke that Lyon-Martin Health Services, a community health clinic that serves primarily queer women and transgender people, was about to close its doors forever, the community rose up even before the official announcement was made.

Within hours of first hearing the news, more than 150 clients, former clients, and members of the community gathered at an emergency town hall meeting to fight to save the clinic. People testified about what Lyon-Martin had meant to their health. Many expressed fears it would close and anger that they hadn't known the clinic was in trouble.

To their credit, two members of the board of directors and interim Executive Director Dr. Dawn Stacy Harbatkin came to the meeting to answer questions from the community. This powerful meeting transformed and dramatically altered the outcome. In response to the opposition, the board backed off closing the center for at least a month and promised the community that there would be at least a month to find ways to save the clinic.

However, the board members also explained that the clinic was in serious trouble and needed to raise more than $500,000 to stay open. By the end of the meeting, a "Save Lyon Martin" coalition was born.

Within a week, more than 700 community members came to a fundraiser that raised more than $60,000, and within a month, more than $300,000 had been raised.

But at the same time, some have asked: should we save Lyon-Martin?

It's a legitimate question. Over the past two years Lyon-Martin expanded its services, almost doubling its staff and patient load. However, the management failed to build the infrastructure to accommodate these changes. One of the known factors that led to the current situation was Lyon-Martin's inability to stay current with its Medi-Cal billing, and there was a significant loss in revenue as a result. A substantial amount of debt is owed to the IRS and a long-term bank loan. Given the financial problems, some say, we should close the clinic; other community health clinics could simply incorporate the 3,500 patients served by Lyon-Martin.

While it's true that the financial issues are troubling, and that hard questions need to be answered, dumping 3,500 patients into a public health system that has been cut to the bone over the last few years would be a disaster in San Francisco. The clinics that serve queer and transgender people are already stretched to the limit. No other place in the city has the capacity and culturally competency to serve this population.

Lyon-Martin has taken on the mission of caring for a group of low-income, mostly uninsured patients who have rarely, if ever, gotten culturally competent care. Almost 90 percent of Lyon-Martin patients are uninsured; 87 percent have incomes below 200 percent of the federal poverty line; 17 percent are homeless; 33 percent are people of color.

As a transgender person who has received poor and even hostile treatment by a health care provider, it doesn't surprise me that in a recent survey more than 50 percent of transgender individuals reported that they have had to teach their health care providers about transgender health care. More than half of lesbians, bisexual, or transgender people report that they avoid health care for fear of discrimination.

In this context, closing Lyon-Martin is simply not an option.

We have many questions about how Lyon-Martin got into this situation and what needs to be done to avoid it happening again. We want the community to have stronger oversight over this important resource. We want people held accountable. But most of all, we want to ensure that we continue to have access to the excellent care that Lyon-Martin has provided to so many of us.

On March 2 at 4 p.m. at the Budget Committee of the Board of Supervisors, Sup. Ross Mirkarimi will be holding a hearing addressing these questions. We hope you can join us.

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