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InTowner Visits With Whitman-Walker’s Director; Finances, New Focus Explained

By Jonah Ghile

Images accompanying this feature can be viewed in the current issue PDF

It is after 10 years of arrearage and the unforeseeable withstanding of a long struggle, that Don Blanchon, Executive Director of the Whitman-Walker Clinic since 2006, and his staff are happy to tout that they have reached goals sought out a decade ago, transforming an AIDS service organization to a full community health center with a four percent operating gain for 2010. Although financially improved, it did not come to pass without hardship and notable sacrifice.

Sustainability, says Blanchon, is the forefront of both his and the board of directors’ primary focus. With 13,000 patients who are treated by the clinic, being able to keep their doors open to run a successful medical business, was a by-all-means unavoidable dilemma that lingered ominously during 2007 and 2008 when the clinic faced a $4 million budget deficits.

“Before my time here I think the board of directors and the entire clinic family struggled with the AIDS service model which is heavily dependent on private donations and local and federal grants,” said Blanchon. “Typically all of those things together oftentimes don’t pay for the costs of what you’re actually providing and in those days we were providing HIV testing and counseling, housing, a food bank, and we had a whole host of services because we really were this comprehensive HIV model for people living with HIV. As times got tight, and as donations moved overseas, our board felt strongly that we needed to change our model if we were going to exist.”

The clinic was started by five gay men who were a product of the LGBT community, and after being predominantly LGBT for its first decade of existence, the ensuing years saw a decline in clients and donations from gay and bi-sexual men and women. This development had a substantial impact on the clinic’s budget which had benefited significantly from the loyalty the LGBT community.

“With the [HIV] epidemic, said Blanchon, and the fact that the virus doesn’t care about orientation, race, or gender, it was our moral and ethical obligation to start serving other groups in the DC community.”

Blanchon, who is keen on the priority of care for the virus, understands the missing presence that once was the LGBT constituency which the clinic represented.

The clinic was able to stay on its feet through its transformation, which began in late 2005, when the financial picture began to deteriorate, necessitating budget cuts and staff reductions.

“We’ve closed programs in Maryland, Northern Virginia, a food bank, an addiction program; we’ve laid off 110 staff in two different restructuring rounds; we’ve had a subset of employees who haven’t received a raise in two years, so the sacrifices are there,” Blanchon said.

As far as clients are concerned, Blanchon told The InTowner that there hasn’t been much they’ve had to yield. A subset of patients who were receiving supportive services such as food bank and housing, while no longer being served by the clinic are instead being referred to other prominent community providers such as Martha’s Table, Food and Friends, and the Capital Area Food Bank. It was ultimately a vital decision that was financially critical to be made in midst of public debate on the viability of the clinic’s future.

“One had to ask the question, if we have a limited amount of resources why would we continue to run a food bank,” Blanchon commented. “As much as that makes us feel good about helping a human being across from us, is that the best use of what we have in terms of a limited amount of money? And from my perspective, the answer was no.”

It was, according to Blanchon, following his appointment as executive director that the clinic’s financial started to improve. As he explained, each and every aspect of the clinic’s operation was reviewed and scrutinized. Operating revenue, being the main focus, was narrowly measured alongside operating expenses beyond staffing alone.

“We did not take a view that we could fund or revenue our way out of this. We are non-profit and we’re reliant on payments from private donors, third party health payers like Care First and Medicaid and Medicare. We don’t set prices and we’re not able to generate our own massive revenue infusion”.

Executive Director Blanchon sees himself as part of a new landscape of progress. Now operating 22 programs, he and his board of directors, he commented, continuously funnel investments into the care-giving mission. Implementation of an electronic health record system, revamped in-house pharmacy, and the welcoming of 30 insurance providers are just a few on the list. These very investments equate to a business-minded philosophy tracking away from the money not-well spent atmosphere that he believes nearly brought about the clinic’s closure. And with reference to the clinic having sold off its valuable former main building at 14th and S Streets and adjoining smaller properties a couple of years ago which yielded funds used to pay off accumulated debt, Blanchon says he is committed to preventing further losses.

“In the past when patients came here, we wouldn’t bill their insurer because we weren’t participating with their insurer so we didn’t have a contract to get paid. Basically we would give free care to someone who was insured. “That’s not a great use as a steward of private donor’s funds.”

Blanchon is most enthusiastic about the progress during the past year. Giving credit for the clinical leadership of Chief Medical Officer Dr. Raymond Martins and his team, Blanchon said that he and the clinic’s leadership were able to stabilize the financial picture while at the same time improve quality health care for the clients.

“As we like to say here, one year isn’t a trend”, acknowledged Blanchon, very much mindful of. the cloud of debt that still looms over the clinic. “We had nine years of losses in a row for $13 million so we’re going to use some of the money to pay off some bills. We also elected not to raise our health care premiums for our employees this fall. [Also], we used some of the operating money to assist in renovation costs.”

Of a $24.2 million budget for 2011, $3 million is attributed to proceeds from fundraising dollars already received. While noting that private source fundraising is still tenuous, Blanchon believes that momentum has started to pick up for the clinic.

“With respect to District [of Columbia] funding from the feds,” according to Blanchon, “reduction in HIV prevention allocation had been made in the last two years. The clinic has been a small recipient of some of those funds to do testing and counseling. The practical reality of that is the clinic receives very little in District appropriated or local funds. Most of what we receive comes from the federal government through Medicare, Medicaid, or Ryan White HIV care funds.”

And, although Blanchon believes that while a reduction in the city budget would hurt the clinic’s funding base, it result in any elimination or reduction of testing and counseling services.

“Sometimes people say it’s better to be lucky than good. In our particular instance, our transformation has really aligned us well for post-healthcare reform implementation. We’re now a health center and take insurance. We can bill claims electronically and that should position us really well for the next few years and in advance of the full healthcare implementation date of January 1, 2014.

Respectful of Ward 1 Councilmenber Jim Graham, the clinic’s long-time former Executive Director prior to being elected to the city council 12 years ago, Blanchon says he plans to do as much for the clinic as Graham was able to do during a dark period of strife and hard times.