Lyon-Martin Health Services Interim Executive Director and Medical Director Dawn Harbatkin

Historic Clinic Serving Trans, Lesbian Communities Needs $500K
Lyon-Martin Health Services has received a temporary reprieve. 

Contrary to early reports, the historic women’s and LGBT health care provider will not cease operation this week. Though the clinic still faces potentially catastrophic financial hardship, representatives now call its Board of Directors’ weekend vote to cease operations Jan. 27 a misstep. 

“We’re going to do the best we can to stay open,” promises Lauren Winter, Chairwoman of Lyon-Martin’s Board of Directors. “We made a mistake.”

While the clinic’s leadership, employees, fellow community service providers and even local government officials pledged to do all they can to keep Lyon-Martin in business, exactly how that is best accomplished was unclear at a hastily organized open forum on the subject Jan. 25.

This past Tuesday, Winter, Lyon-Martin’s Board Treasurer Peter Balon and Clinical Director and Interim Executive Director Dr. Dawn Harbatkin addressed more than 100 concerned clients, community members, employees and supporters at San Francisco’s LGBT Community Center. The trio fielded questions ranging from how the public can help the clinic stay open to specifics about the organization’s debt.

“I want to know exactly how much money we’re talking about here,” one concerned female client demanded. “And how much does it cost to keep the clinic open going forward?”

To their credit, Lyon-Martin reps did not flinch. During an hour-long question and answer session, which was followed by a closed-door community brainstorming session, they spoke frankly about the clinic’s financial crisis. 

According to Balon, the clinic needs $500,000 within the next two weeks to escape bankruptcy altogether and continue offering all its current services. Half that amount would side-step Chapter 11 for Chapter 7 bankruptcy, he said, allowing the organization to continue restructured operation.

While news of the 30-year-old clinic’s financial woes caught the public off-guard, it was no secret to Dr. Harbatkin. Though she wishes things were different, a career working in small, community-based healthcare has proven this surprisingly common, she says.

“In community clinics, ‘OK’ is a relative term,” Dr. Harbatkin explained during an interview Tuesday night. “It means we’re able to pay the staff. We’re able to pay the bills. Things don’t get too delayed. The people we owe money to, we don’t owe them too much.”

Dr. Harbatkin knew finances were not good at Lyon-Martin, California’s only free-standing community clinic with specific focus on lesbian and transgender health care. She did not realize just how bad they were until after she took over as Interim Executive Director last Thanksgiving. The true gravity settled in during a meeting between the staff and Board of Directors several weeks later. 

“We knew we were in trouble,” Dr. Harbatkin confessed, “But this is more trouble than we thought.”

“It wasn’t until all the numbers came in that it became obvious – terribly obvious – how glaring the problem was
 and just how immediate,” Winter shared with the crowd.

Like many attending the impromptu community forum, Dr. Harbatkin says she was shocked by the Lyon-Martin Board of Directors’ “unexpected” decision to close its doors. “I was quite surprised,” she admitted privately. “I had a conversation with them urging them to reconsider, and they obviously have.”

“Without going into gory details, the Board - the mistake I mentioned – is we reviewed [closing] from the perspective of a business rather than maybe a health clinic,” said Winter. That led to the Board’s Jan. 23 vote to close the clinic just four days later.

Outwardly, it might seem the Board did not consider the decision’s impact on individuals receiving treatment at Lyon-Martin, named for legendary lesbian activists and wives Phyllis Lyon and Del Martin. Winter says this is untrue. 

“I’m transgender and a patient, so I know how important it is,” explains the Board’s Chair, who first discovered Lyon-Martin five years ago while searching for a primary care provider who understood transgender needs, “But, as a Board, we’ve been overwhelmed by keeping the clinic afloat for so long.”

Winter now admits the Board ultimately gave greater priority to “running a responsible, ethical business” than ensuring the clinic’s 2,500 patients - many who are unemployed and either un- or under-insured - safe, smooth transitions to other care providers. However, she says the group hoped to use the four-day window to investigate all options and determine how best to transition should the clinic close. 

“We don’t have a transition plan yet,” Dr. Harbatkin admitted, “Which is why the Thursday close date was not a good idea.” 

Unfortunately, Winter says news of the Board’s decision spread quickly. As the information hit the Internet, spreading all the more rapidly, it brought instant backlash. Says Winter, “All hell broke loose.”

As word of the clinic’s planned continued to spread, transgender activists Gabriel Haaland and Jackson Bowman sprang to action, using social networking websites like Facebook to plan the forum, increase communication and bring those affected by and involved with the decision together.

“We really wanted to solicit what the thoughts of the community are beyond closure,” says Bowman. “People were really interested in figuring out ways to keep healthcare and nonprofits accountable to the communities they serve.”

The meeting drew the attention of members of San Francisco’s Board of Supervisors. Both District 8 Supervisor Scott Weiner and District 9 Supervisor David Campos addressed the crowd, pledging whatever support possible for Lyon-Martin.

“What is happening to Lyon-Martin is not the exception,” said Campos. “Many, many community-based organizations are going through this.”

Campos pointed to the City’s recent precedent of stepping in and assisting LGBT-focused organizations such as the Community Center and, more recently, Pride. He also noted the Board of Supervisors plans to offer the Asian Art Museum financial support in the near future.  

Campos suggested the City’s elected officials could make a similar commitment to prevent Lyon-Martin closing. First, though, he called for accountability. “It’s not about blame,” he said, “It’s about accountability and responsibility.” 

“We have a population here that needs to be served, and the City can’t just look the other way,” Campos said. “But we need to make sure this doesn’t happen again.”

Winter, Balon and Dr. Harbatkin pinpoint an extreme backlog in billing, the clinic’s rapid expansion – including absorbing a significant number of patients and responsibilities after New Leaf closed last year and ceased providing mental health services to the LGBT community– and management oversights as reasons for the deficit. All were committed to returning the organization to a place of financial stability and trustworthiness.

“We understand how people would lose faith in our ability to effectively run this organization,” says Winter. “Most on the Board would be more than willing to work in finding our own replacements, once the clinic is running again, just to ensure people have a Board they can trust.”

AIDS Housing Alliance/San Francisco Executive Director Brian Basinger went one step farther than Sup. Campos in discussing the precedent City elected officials set providing assistance to community service providers facing “cash flow issues.” He said not only should they do so again to save Lyon-Martin, they must. 

Basinger also urged attendees to see the bigger picture. Rather than assigning blame for Lyon-Martin’s failure to individuals, he called the LGBT community as a whole to task.

“We have to understand this is in the context of the economy and the context of our funding decisions as we pursue our larger civil rights agendas,” Basinger said. With the gay community contributing much of its money to causes like Marriage Equality and the repeal of Don’t Ask/Don’t Tell, he says other needs are forgotten or overlooked.  

“When we pump money in that, we have to understand that money comes from somewhere else and at the expense of those in need,” he said. “The reality is, that’s exactly what happened here.”

Outspoken queer activist Michael Petrelis, whose online blog helped break news of the closure, agreed loudly. “My community here is hurting, and I’m told my ‘gay agenda’ is getting a wedding cake and getting a gun,” he railed. “I need AIDS drugs. I need healthcare.” 

When the audience responded by cheering loudly, the often controversial Internet personality cut them off. “Stop the applause,” he demanded. “Fuck you! Wake up! Take action!”

According to Bowman, action is exactly what many plan now that they are aware of the clinic’s dire situation. From young people organizing a bicycle coalition to distribute information about Lyon-Martin and upcoming fundraising efforts to others pressuring the Department of Public Health to bail the clinic out, he says many left the community forum feeling empowered.

Meanwhile, the flood of support surprised Winter. Prior to the decision to close the clinic, she says the Board reached out to other area organizations, service providers and resources asking for help, suggestions or guidance. They received little or no response.

“We felt very isolated, alone in this process,” she admits.

“What we didn’t know is there is a community there beyond what we know, and they are there to help us,” Winter says. “It’s amazing and impressive.”

“Hotties for Homo Health Care” – A Fundraiser for Lyon-Martin Health Services – is scheduled Sun., Jan. 30, 7-10pm, at El Rio (3158 Mission at Precita). $5-$20 sliding scale donation.