OAKLEY -- Nearly 18 months after opening, Oakley's clinic for those with little or no health insurance is, by all appearances, thriving.

Those keeping an eye on the bottom line are more apt to describe its financial health as guarded, however.

"It's a chronic condition," said La Clínica de la Raza's Chief Executive Officer Jane Garcia said with a rueful laugh as she described the struggle to keep her organization's clinics in the black now that future funding from a major revenue source is in question.

The Contra Costa County Board of Supervisors is scheduled to consider awarding a one-time grant of $300,000 on Tuesday, but even if it does, Garcia doesn't know what will happen when that money runs out.

The Oakland-based nonprofit operates Oakley's primary care clinic and 30 others in three counties.

But it's the expansion of that storefront site on Main Street that was the focus of an update the Oakley City Council received last week, when a spokeswoman for the agency talked of the growth the facility has experienced since it began seeing patients in December 2011.

Until then, Oakley had been the only city in East Contra Costa that didn't have a place where low-income patients and others without adequate medical insurance coverage could go to get basic medical care.

The clinic initially was seeing patients 20 hours a week, but the facility's business hours doubled in January and, with an average of 10 new patients registering every day, its patient load has nearly quadrupled. La Clínica logged 154 visits during its first month of operation it had 587 in March.


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And with 3,563 visits that first year, the clinic exceeded its goal by a wide margin.

Moreover, its five-member staff has expanded to 11, all but one of them full-time.

The roster includes a full-time doctor and two nurse practitioners, three medical assistants and a behavioral health clinician who evaluates children suffering from anxiety, depression and hyperactivity, and provides counseling.

Although La Clínica doesn't offer an on-site pharmacy, it has a contract with Walgreens in Brentwood that enables the uninsured and very poor to get their medications at a discount.

Children who require a dental checkup can see the pediatric dentist who comes by once a month to provide free screenings; those who require treatment are referred to La Clínica's Pittsburg site. Free dental screenings are also available three times a year to adults who are at least 50 and have diabetes.

But the clinic has encountered difficulties as well.

Recruiting Spanish-speaking health care providers can be tough, say La Clínica officials.

"The biggest challenge is not finding a nurse practitioner but finding one that is bilingual," said Communications Specialist Yanet Luna. "Many of our patents are monolingual, so it's vital to have (someone) who can speak their language."

Although Oakley's site is in the process of replacing a nurse practitioner who just left, it's looking for a part-time pediatrician to round out its services, Luna said, noting that the clinic wants to serve the entire family even though most of its patients are adults.

Recruiting qualified people is also tough because La Clínica can't offer competitive salaries, said Viola Lujan, director of business and community relations for the clinic.

"It's been actually quite difficult to recruit medical providers," she said.

In addition, many people are put off by Oakley's location, Lujan said.

"I guess it's perceived to be a little bit out of the Bay Area, so it looks like a long commute," she said.

And then there are the finances: Although the Oakley clinic is in the black and the city has guaranteed its lease for seven years, it's not easy maintaining a balance between patients who don't have insurance and those who do, Lujan said.

The number of those lacking coverage increased when the clinic expanded its hours, and they now comprise 58 percent of the patient load, Garcia said.

What's more, the facility collects only about 25 cents on the dollar from those who pay on a sliding fee scale, she said.

And now Garcia worries that the help La Clínica has been getting from the county to serve indigent adults is in jeopardy.

Until the end of December, La Clínica together with a community health center in Richmond were operating under a three-year, $1.1 million contract with the county to care for this uninsured demographic.

La Clínica's Pittsburg site is already deficit spending, "and Oakley is about to be in the same situation," she said. "It's right around the corner."

Contact Rowena Coetsee at 925-779-7141. Follow her at Twitter.com/RowenaCoetsee.