A network of North County clinics serving low-income families will be under new management next year, owned and operated by the nonprofit Ravenswood Family Health Center, it was announced Friday.
MayView Community Health Center, which has provided care for needy patients in Santa Clara County since the 1970s, has reached a deal in which all of its assets, employees and operations will be transferred to Ravenswood by April 2020. The name "MayView" might stick around as a local brand for its clinics located in Palo Alto, Mountain View and Sunnyvale, but the deal largely ends the nonprofit's long tenure as the North County's health care safety net.
Ravenswood CEO Luisa Buada said the merger, which will be subject to a vote by the boards of directors of both organizations next week, is the best path forward for MayView's patients. Nonprofit clinics are difficult to operate on a balanced budget while serving an ever-increasing number of uninsured and underinsured patients, she said, particularly with limited reimbursement rates and high physician salaries in the Bay Area.
Consolidating the clinics into one larger organization is one way to get around those challenges, Buada said.
"The stresses MayView has had in the past are going to be a thing of the past," she said. "So the focus will be on patient care delivery and expanding services."
MayView serves more than 9,000 patients each year, the majority of whom are Mountain View and Sunnyvale residents. There are no county-operated health clinics in northern Santa Clara County, leaving organizations like MayView and Planned Parenthood to fill the gap. After the transition, Ravenswood is expected to serve a combined 27,000 patients with a little over 100,000 patient visits each year, according to MayView CEO Ken Graham.
MayView has struggled in past years to stay solvent in a difficult health care market, and there are a lot of forces that make consolidation a tempting option. Perhaps the most important factor is that Ravenswood is a Federally Qualified Health Center (FQHC), granting it a line of federal funding to provide health services in underserved areas.
MayView had applied for FQHC status to improve its finances, but it was denied in September. This sparked serious discussions with Ravenswood about the acquisition plans, Santa Clara County Supervisor Joe Simitian said.
Graham said he believes Ravenswood taking over the MayView clinics will "unify" the safety net across county boundaries -- Ravenswood's flagship clinic is located in East Palo Alto in San Mateo County -- and will mean better services for patients and stronger organizational support for staff.
Buada said the merger makes sense, given that both organizations have fought to provide health care to underrepresented and marginalized residents, with special considerations for cultural competency in diverse communities. Unlike a corporate merger that might come with layoffs and major restructuring, Buada said patients really shouldn't see much of a difference.
"It doesn't take anything from MayView. It's not like other businesses," she said.
Under the current plans, the staffing at all three of MayView's clinics will remain the same, and patients who can't afford the full cost of care will still be eligible to pay a reduced fee on a sliding scale based on income. Even the IT and electronic health records should be relatively easy to combine, as MayView and Ravenswood both use the same providers.
Subsidized health care for needy residents has gone through major shifts in Mountain View in recent years. In 2016, the Mountain View RotaCare clinic on Grant Road shut down, forcing hundreds of patients who relied on its free services to transfer to MayView. Now, all patients of MayView will be transferred to Ravenswood.
Unlike RotaCare, Graham said the planned merger with Ravenswood will be relatively seamless. The goal is that not one single MayView patient will receive a letter saying they have to go somewhere else.
To assist in the transition, the Santa Clara County Board of Supervisors is scheduled Tuesday to vote on a $625,000 contract to MayView for financial support through the end of March. The money will be used as "bridge" funding to allow MayView to continue to provide health care services to patients during the "orderly transition of patients and patient care from MayView to Ravenswood," according to a county staff report. MayView serves 200 uninsured patients per month -- the second highest of all health centers in the county -- in addition to Medi-Cal patients who would otherwise have to travel to Milpitas or Sunnyvale for care.
In a statement, Simitian called the funding a critical stopgap measure to ensure MayView's services continue in the lead-up to the acquisition. Assuming the merger succeeds, he said the organization will be assuming a vital role in health care that MayView has filled for decades.
"MayView has been an invaluable partner in the North County for almost half a century," Simitian said in the statement. "And we are so excited that Ravenswood will continue to carry the torch that MayView lit 47 years ago."
The funding agreement also stipulates that, if the acquisition doesn't happen for some unforeseen reason, the county will have "first right of refusal" to acquire the three MayView sites.
Precise details on a MayView-Ravenswood merger, including how to integrate a portion of MayView's board of directors into Ravenswood's organizational structure, have yet to be determined. Graham said it's unclear what role he might have at Ravenswood once the merger is complete.