Lyon-Martin Health Services, the pioneering San Francisco clinic that has served women and transgender people for more than 30 years, will start accepting new patients today - eight months after it nearly closed due to financial problems.
The clinic's board of directors voted in late January to shut down the health center, but Lyon-Martin's patients and supporters decided to put up a fight. They raised more than $500,000 within a matter of months while the clinic's staff worked internally to stabilize operations, cut expenses and find additional revenue sources for the Market Street clinic.
The result has been a tenuous recovery. The clinic, which was able to stay open to existing patients but couldn't take on any new ones, remains more than $1 million in debt, but has emerged from the crisis with an invigorated sense of commitment from the people who helped to save it.
Save Lyon-Martin, an ad hoc group that sprung up as a Facebook campaign within hours of the announcement to close, has now become an integral part of the clinic's fundraising efforts.
"Our backs were against the wall," said Pike Long, a clinic patient for the past three years who immediately got involved in Save Lyon-Martin's efforts. "More often than not, we have a difficult time accessing competent, respectful, affordable local health care."
Long, 31, a lesbian, now serves on the clinic's board of directors.
The clinic's roots
Named after pioneering lesbian activists Phyllis Lyon and the late Del Martin, Lyon-Martin in 1979 became the world's first clinic dedicated to providing primary care to lesbians and still is the state's only freestanding community clinic with a specific emphasis on lesbian and bisexual women and transgender people.
"Lyon-Martin serves a very particular need in the San Francisco Bay Area community that no one really does," said Marj Plumb, a former executive director of the clinic and newly elected board chairwoman. "You could go to Kaiser and find a lesbian physician or even a transgender-friendly physician, but you're not going to get the kind of care Lyon-Martin provides to those patients, and certainly not to poor and uninsured populations."
While health resources for lesbians have improved over the past three decades, studies still show that lesbians are more likely to suffer from depression and alcohol abuse. They're also more likely to delay getting care compared with straight women. Transgender patients describe discrimination from health providers as a common occurrence.
Not first time in the red
But despite the need, this is not the first time Lyon-Martin has gone into the red and faced potential closure.
In the late 1990s, the clinic fell $140,000 in debt because of management problems, billing errors and a steep drop in donations. Similar but even more dramatic problems have plagued the clinic this time, made worse by an economic crisis that increased demand for health services from an increasing number of unemployed and uninsured patients.
"Lyon-Martin has two big strikes against it as a clinic: It's small and it has a niche market," Plumb said.
By the end of the year, Lyon-Martin needs to attract more patients, from the current 2,300 to about 3,000, and increase the share of patients reimbursed through government programs such as Medi-Cal as well as private insurance, said Dr. Dawn Harbatkin, the clinic's medical director and interim executive director. While not a free clinic, about 70 percent of its patients are uninsured, which means the clinic picks up the bulk of the tab.
The clinic needs a permanent executive director, Harbatkin said.
Meanwhile, Save Lyon-Martin has launched "30 Days of Health," a campaign that encourages participants to pick a health goal and recruit supporters to fund the goal and benefit the clinic.
"The fundraising has been national in scope," Harbatkin said. "All that being said, this does not take us to a place of ongoing stability."
Patients Vega Darling and Leeroy Joyce said they don't know where they'd get their health care if Lyon-Martin didn't exist.
"There are not a lot of places you can get affordable, competent care being a trans person," said Darling, 32.
"I won't get misgendered; I won't get mis-pronouned," said Joyce, 29, of the sensitivity of the staff.
Nahiel Nazzal, 31, isn't lesbian or transgender but has chosen to get her care at Lyon-Martin because she likes the quality of care she receives.
"I'm a San Francisco native, so coming to a place like Lyon-Martin, I feel like this is a symbol of the type of diversity the city embodies," she said.