Special Projects
Clinic Overcomes Crisis By Employing Shared Resource Model
  ike other clinics throughout California, East County Health Services (ECHS) faces many pressures maintaining fiscal health at a time when fewer public funds are available to support their work. But when the executive director and other key staff left the organization and a key revenue-producing partnership was terminated, ECHS was pushed to its limit and plunged into crisis.
ECHS provides 40,000 client visits a year and is the primary provider of health care services in the eastern part of San Diego County, a region with no county-owned hospital. Keeping ECHS’ doors open was critical to ensuring that the working poor,
uninsured residents who rely on the clinic would have continued access to health care.
  A consulting team presented ECHS’s board with possible solutions. The board opted for a
turnaround plan based on sharing human resources with another clinic that had expertise to share.
Now the executive director, chief financial officer, human resources director, information
technology manager and the billing and accounts payable staff of Escondido Community Health Center (ECHC), located 40 miles away, provide
services for ECHS.
“The distance between the two organizations is not the issue you might think it would be,” said Tracy Ream, executive director of ECHS and ECHC. “I am the only member of the shared team that
regularly divides time physically between the two sites. Technology has made it very doable.”
In December 2000, TCWF provided a two-year, $125,000 grant to ECHS for core operating support to sustain the organization as it implements the turnaround plan and solidifies its infrastructure.
 “I appreciated ECHS’ candor about the challenges they were facing because of their financial situation and the loss of the organization’s leadership,” said Cristina Regalado, TCWF program director. “It gave us a better idea about how we as a Foundation could help stabilize the organization.”
After ECHS restructured, they encountered an obstacle with the U.S. Department of Health and Human Services. As a federally qualified health center, ECHS was required to have an executive director employed by the organization.
“Since I am technically an employee of Escondido (ECHC), we requested a waiver of this requirement,” Ream said. “At first they did not understand what we were doing, but they came around and we got our waiver
while we sort out long-term relationships.”
Two years have passed since ECHS initiated its turnaround plan and it is now
on more solid footing. ECHS’ board approved a second two-year term with the
shared team. The organization is now focusing its efforts on implementing more
efficient systems for patient flow, patient satisfaction and quality. Another
important focus is to set up a system of information sharing and cooperation
between the two organizations’ boards.
“The concept of seasoned nonprofit professionals sharing their skills and
experience with another organization makes a lot of sense,” Regalado said. “The
shared resource model is one that other health organizations may want to
consider.”
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