API Wellness Center Expands Clinic Hours

The Asian and Pacific Islander Wellness Center has expanded the hours of its recently remodeled Wellness Clinic as it continues to make changes now that it has federal status.

The clinic, housed in a suite of upgraded exam rooms and offices on the fourth floor of 730 Polk Street a short walk north from San Francisco's Civic Center area, is now open Mondays through Fridays. Its hours and staffing are expected to grow as it ramps up its services in order to care for 4,000 patients by 2017.

"Even up to the last day of the remodel things were disorganized. Once the new signage went up, it felt like we are in a real health center. That was not just my reaction but I also heard that from staff and clients," said Dr. Tri Do, API Wellness Center's chief medical officer, as he showed off the upgraded facility last week. "Everything is so new and brought up to the 21st century."

When it first opened in 2011, the clinic was staffed by volunteers and provided services three days a week. The agency set about upgrading the clinic environs in August 2014 and most of the remodel work, at a cost of roughly $110,000, was completed last October.

"It's been a huge change," said Castro resident Juliette-Marie Somerset, 55, a black transgender queer woman who became a client at the clinic last May. "The space has been transformed into a proper clinic."

Work is ongoing to build out a new space for the clinic's reception desk and an office for a newly hired eligibility specialist who works with patients to sign them up for health insurance.

There are now four private counseling suites and a dedicated community art therapy studio. API Wellness Center formed a partnership with the University of San Francisco's School of Nursing and Health Professions to provide mental health counselors for clients.

Currently, three clinical psychology doctoral students from USF each see up to 10 clients and spend 20 hours a week at the Wellness Clinic. David A. Martinez, Ph.D., an assistant professor at USF who also sees patients at the clinic one day a week, supervises them.

"It is nice to see the transition; the space has definitely improved," said Martinez. "I think that has been really good for the students and the clients."

In addition to the three redesigned exam rooms - one is named for the agency's founding medical director, Jason Tokumoto, and his partner, Michael Sanders - the clinic has brand new equipment. There is also a laboratory area for the storage of blood draws and space to conduct tests on-site for HIV and other diseases.

"We have been on an incredible journey for 29 years as an organization, and I think the last six months have really been an exciting journey for us transforming into a health center where anyone in the Tenderloin, anyone in San Francisco, can get their health care needs here," said Lance Toma, the agency's chief executive officer, who in 2007 created a task force that recommended the agency open a free medical clinic.

As the Bay Area Reporter reported in August, the U.S. Department of Health and Human Services designated the Wellness Clinic last summer as a Federally Qualified Health Center, the only community health center in San Francisco to receive such a designation. The qualification comes with an annual allocation for the next two years of $650,000 to operate the medical clinic, which saw 650 clients in 2015 at a cost of roughly $1 million.

The clinic budget has now grown to approximately $2.5 million. The figure includes medical clinic operating expenses, according to agency officials, as well as funds for integrated non-medical support services, such as case management, behavioral health, and community support.

The clinic staff includes eight case managers, a medical social worker, nurse practitioner and four peer navigators/advocates. It is transitioning from having a second volunteer nurse practitioner and four volunteer nurses to a fully paid staffing model due to the FQHC award.

"We want anyone who wants the kind of approach to health care we have to come and get their health care from us. It is possible now with this designation from the federal government," said Toma.

Expansion Increases Patient Count

Since expanding its hours in early December, the clinic is now seeing more than 700 clients, 65 percent of whom identify as LGBTQ. Roughly 43 percent of clinic patients live in the Tenderloin, and the clinic sees people aged 18 to 60 and older.

"We have really hit the ground running. We have gone from a trot to a sprint," said Do. "We are really able to provide comprehensive health services and see that people have the same provider visit after visit."

According to the agency, 31 percent of patients who identify as female also identify as transgender women, while 9 percent of patients who identify as male also identify as transgender men.

Among male patients, both cisgender and transgender, 32 percent identify as gay or bisexual. Less than 8 percent of female patients, both cisgender or transgender, identify as lesbian or bisexual.

Ninety percent of clients are people of color, and 45 percent of patients are insured. More than 45 percent of the current patients are on some form of Medi-Cal and therefore qualify as low-income.

"We want to serve the folks who are not getting any care," said Toma, who stressed that people with non-emergency medical needs should turn to the Wellness Clinic rather than go to a hospital emergency room for treatment. "They can come here and access doctors, nurses, case managers and social workers regardless of their health insurance status."

Clinic patients can also utilize any of the agency's other services, from a mobile shower that comes once a week to its Trans Thrive drop-in center for transgender individuals. It also began a PrEP program last year aimed at prescribing the once-a-day HIV prevention pill to young gay and bisexual men of color and transgender individuals.

Asked what some of the top medical needs of its patients are, the agency said primary care issues such as hypertension management, diabetes, and heart disease frequently arise, as do mental health and transgender health issues.

Somerset, president and CEO of Somerset Philanthropic Advisors, told the B.A.R. that prior to moving to San Francisco from Massachusetts last year she had been advised to seek out API Wellness Center to be her primary care provider. Although she had been receiving quality health care back east, after she transitioned, Somerset felt she no longer was fully supported by her medical providers.

"I have always lived in great urban cities and always had access to excellent health care. But excellent health care, I have discovered, doesn't always equal affirmative care," said Somerset, who has private insurance.

So impressed with the medical care she has received at the Wellness Clinic, Somerset last month joined API Wellness Center's board of directors.

"I like to describe it as we all have our favorite coffee shops we can pop into and feel comfortable sitting in as long as we want. I feel that way about API Wellness Center and the clinic," she said. "I feel this is a community to me, whether I am accessing clinic services or dropping by for a support group. ... I love the diversity here. I love it really is a center for us all."

Agency officials are currently negotiating membership in various health networks and managed care networks so that more clients can select the Wellness Clinic as their "medical home," said Do, whether they have public insurance, a Covered California plan, or private insurance.

"We are accepting Anthem Blue Cross and Aetna. We can also see any Medi-Cal patients for sensitive health services (reproductive and sexual health)," Do explained. "We are also working with United Healthcare, Blue Cross/Blue Shield of California, the San Francisco Health Plan, and Healthy San Francisco to ensure the broadest access to care."

The clinic operates on a sliding scale fee schedule, based on a person's insurance and/or ability to pay. Currently the fees range from a $20 copay for new patients/$10 for existing patients making less than 138 percent of the Federal Poverty Level to a $50 copay for new patients/$40 for existing patients making between 200 to 400 percent of the FPL.

"We want to be sure folks understand that we will not turn anyone away and we do have the power to waive fees for folks who are unable to pay for health care," stressed Stephanie Goss, the agency's spokeswoman.

The clinic is open most weekdays from 9:30 a.m. to 6 pm. except on Thursdays when its hours are 11 a.m. to 7:30 p.m.

To make an appointment at the Wellness Clinic, call (415) 292-3400 or email [email protected]

Anyone interested in securing the naming rights for the clinic's remaining two exam rooms can do so for a minimum donation of $7,700. Contact the center's development manager Sara Kunitake at mailto:[email protected] or call (415) 292-3420 ext. 373.?