Refuting Twisted Thinking

As a volunteer physician and vice president of the board at the Laguna Beach Community Clinic, I would like to reply to the letter in the Oct. 16 Independent (“Root Cause”), addressing the homeless situation in Laguna.

It was fascinating to me that a reader (Mace Wolf) would hold the clinic responsible, along with two other organizations, as a root cause of homelessness. He writes, “I want to see all three of these organizations zoned out of town or charged appropriate taxes and fees so that these organizations are forced to internally bear the costs of their support for homelessness rather that externalizing them onto the rest of us.” He wants to apply fees and taxes to every donation, hand out, or “client encounter” within these organizations at least to an extent that they are required to “bear the full public cost of the existence of Laguna Beach’s homeless population.”

If this attitude truly reflects the thoughts of more than a handful of Laguna residents, then we in Laguna are in great need of dialogue and education among ourselves.

Speaking on behalf of the Laguna Beach Community Clinic, the perception of this organization is totally in error. It is no longer a “free” clinic. It is supported by grants, government programs (Medicare, mediCal, MSI), philanthropic dollars, fundraisers, and sliding scale patient payments. It serves the under insured and the uninsured. As far as I am aware, it remains the only Orange County clinic that will continue to address a patient’s health problem even if he/she has zero resources to pay, and the clinic has never closed its doors to new patients because of over enrollment and thin funding. Almost all of our patients have an employed family member even though their income may be well below the federal poverty guidelines.

Our fastest growing segment of patients is the middle class person who has always had medical insurance through work and a personal doctor, but who is now unemployed, uninsured because of an inability to afford COBRA payments, and now without a doctor, especially if previously a member of an HMO.

The clinic also serves many other groups without insurance – the small business owner, artists, chefs, kitchen workers, nannies, gardeners, clerks, etc. Serving as a medical home to many of the uninsured and because of an open door to “walk ins,” the LBCC saves the taxpayer thousands of dollars annually by keeping under-funded patients out of the local emergency room and as a referral center for patients without funding sent in follow up by E.R. staff after treatment.

The clinic keeps the working poor population in the work force by treating chronic disease such as high blood pressure and diabetes and achieves results far exceeding the national average regarding successful control.

Laguna Beach residents perhaps do not understand what a valuable resource they have in their town. Attention to community health benefits us all. Diagnosis and timely treatment of a patient’s communicable disease, cancers, diabetes, hypertension, etc., prenatal care, and preventive care affects not only the individual and their family but, indirectly, the entire community.

Homelessness affects many communities. It is estimated that in Orange County, there are 17,000 children living in shelters, cars, parks, motels, or with other families – a 30 percent increase over last year. There is a record number of foreclosures, and unemployment is almost at 10 percent in California.

There have been many nonprofit programs trying to address affordable housing and homelessness issues. Irvine’s Families Forward, for one, is a superb example of a community response, providing apartments for homeless families as well as the counseling required to ensure a successful return to the work place, food to assist the family budget, clothing as needed, school supplies for the children, etc. It would be a fantastic leap to believe that Families Forward somehow fueled the growing size of this unfortunate group.

Housing affordability, failing schools, juvenile crime, gang violence, child and domestic violence are all problems to be solved. To solve these problems will require collaborative and creative approaches among multiple segments of our community.

To say that the Friendship Shelter, the Resource Center, and the Laguna Beach Community Clinic are responsible for the homeless presence in Laguna is twisted thinking. To suggest that these non-profits be taxed or run out of town for trying to address some of the problems of the homeless strikes me as bizarre.

On the contrary, to truly address chronic homelessness, a strategic public policy along with counseling, mental health programs and addiction treatment centers, as well as a unified public health policy, would all contribute immensely to successful outcomes.

In the meantime, we should be proud that there are people who gather the resources they can, where they live, to try to address societal problems.

Instead of pointing fingers of blame, we should be working together to find lasting solutions.

Pamela Lawrence, MD, also known as Pamela Horowitz, is a Laguna Beach resident, LBCC board member and volunteer physician.