Doctors: Imperial Beach Clinic for Low-Income Patients ‘Is Falling Apart’

Doctors at the Imperial Beach Community Clinic, a federally qualified health center providing healthcare to 10,000 uninsured and low-income patients in Imperial Beach and surrounding communities, are publicly accusing clinic leaders of mismanaging the 54-year-old community institution, resulting in a budget crisis, a staff exodus and lapses in patient care. 

In an open letter posted last week on social media and in subsequent interviews with Voice of San Diego, doctors and other medical providers at the safety-net clinic said the clinic is close to running out of money to pay its bills and is losing key staff at a time when federal healthcare cuts make providing affordable care to low-income patients more crucial than ever. 

“The clinic is falling apart,” doctors said in the open letter, which was posted on July 23 to the community Facebook group Imperial Beach Happenings. “Providers are leaving. Patients are confused. Test results are delayed. The clinic is suffering and the community is being put at risk.” 

Medical staff interviewed by Voice of San Diego said 18 doctors and other medical providers have left the clinic in the past two years. Three more plan to leave within the next two months, providers said, leaving just four doctors, eight nurse practitioners and one physician’s assistant. 

Two weeks ago, the clinic was forced to cancel or reschedule 700 patient appointments after the departure of the clinic’s chief medical officer left half the clinic’s nurse practitioners without medical supervision required to see patients. 

On July 25, the clinic laid off 28 employees, roughly 10 percent of the staff. Medical providers said clinic leaders told them prior to the layoffs that, without reducing staff, the clinic would be unable to pay its bills in August. 

“We had been told [previously] that we were financially sound,” said Stephanie Hsieh, a physician’s assistant at the clinic. “That turned out not to be true.” 

Clinic CEO Albert Pacheco acknowledged in a statement that clinic operations had been affected by what he called “a thoughtful and necessary transition [to] ensure we are positioned for long-term strength, operationally, financially and culturally.” 

Pacheco, who assumed leadership of the clinic in June, did not specify why the clinic needed to restructure or what exact changes he and other leaders plan to make. 

But he stressed that changes were being made “with care and urgency to protect patient access, ensure fiscal responsibility and restore long-term stability across our systems. [The changes] were not optional. They were essential to securing the clinic’s future.” 

Clinic spokesperson Bailey Golden confirmed that the clinic laid off 28 employees last month, though she said the layoffs affected only medical assistants and administrative staff, not medical providers. 

Bailey also confirmed that the recent departure of Chief Medical Officer Courtney Summers-Day resulted in 700 patient appointments being cancelled or rescheduled because the clinic had not assigned a new physician supervisor for the nurse practitioners overseen by Summers-Day. 

Bailey said the clinic hired a new chief medical officer on Tuesday and nurse practitioners are now able to see patients. 

The Imperial Beach Community Clinic is what regulators call a federally qualified health center. It serves as a nonprofit safety-net provider of primary care for uninsured or minimally insured patients. The clinic’s main source of revenue is reimbursement from state and federal health insurance programs. 

Like other federally qualified centers, such as Family Health Centers of San Diego and San Ysidro Health, the Imperial Beach clinic serves some of its community’s most vulnerable patients. It offers services based on a sliding scale according to what patients can afford. 

Medical providers at the clinic said many of their patients had grown disillusioned by the clinic’s recent troubles. 

“Today I had a patient tell me that they waited on hold for 40 minutes to schedule an appointment and then got hung up on,” said Katherine Allen, a nurse practitioner at the clinic. “[Patients] are asking the doctors, ‘Are you going to stay? Are you going to take care of me? Because everyone else left.” 

Records show that Pacheco is the sixth CEO to lead the clinic since 2021, including one instance when a doctor stepped in to lead the organization following the abrupt departure of a previous CEO after less than two years on the job. 

Medical providers said in their open letter that the clinic had enjoyed a long period of stability under previous CEO Connie Kirk, who retired in 2021 after years of leadership. 

Since then, said one provider, who asked to remain unnamed for fear of retribution by clinic leaders, “there’s been tremendous turnover at the CEO level fueled by mismanagement by the board of directors.” 

Voice asked to speak with Board Chair Monica Jaikaran, who tax documents show has led the board since 2021. 

In response, clinic spokesperson Golden said in a statement, “The Board of Directors adheres to [federal guidelines] for health center boards and fulfills its oversight duties in accordance with federally mandated roles and responsibilities. The Board is actively engaged and committed to collaborative, mission-aligned decision-making.” 

Tax forms and routine audits show that, during the decade prior to CEO Kirk’s retirement, the clinic reported more revenues than expenditures in all but one year, sometimes ending the fiscal year with more than $2 million in net income. 

In 2022, the clinic’s financial fortunes reversed. It ended that year more than $385,000 in the red, according to tax documents. The following year, losses rose to nearly $810,000. 

The clinic stabilized its finances under a new CEO in 2023. But medical providers said the effort to maximize revenue, especially an increase in daily patient volume and a rushed transition to an electronic record-keeping system, made serving patients almost impossible. 

“Departments like Behavioral Health, Referrals, Operations and the Call Center were gutted,” providers said in their open letter. “The phone system failed. Medical records piled up. Lab results went unread, sometimes for weeks. Staff morale was at an all-time low, and we felt our efforts to voice our concerns went unheard.” 

Carole Veloso, the CEO who instituted the operational changes, left the clinic in October of last year after just one year and three months on the job. 

Golden said both the clinic’s current number of patients seen per hour by providers (2.4), and the clinic’s overall rate of staff turnover are below the California state average. 

The clinic uses “an industry-standard electronic health record system [and provided staff with] initial onboarding and ongoing training” to use the system, Golden said. “We continue to support staff as they build comfort and proficiency with the platform.” 

Medical providers said they are cautiously optimistic about the current CEO, Pacheco, whom they described as forthcoming, transparent and committed to turning the clinic around. 

But they remain at odds with the board of directors. In response to the providers’ open letter, the clinic directed its lawyer, Kathryn Fox with the corporate law firm Buchalter, to send a cease-and-desist letter threatening legal action against Priscilla Campos, the family medicine doctor who posted the open letter. 

Providers said they are now pooling their money to help Campos hire a lawyer to defend herself. 

Asked about the cease-and-desist letter, Golden said, “We value the input of our staff, patients and the community…However, to ensure that IBCC can continue to provide these services, IBCC has taken and will take necessary steps to protect the organization. This includes ensuring that individuals do not make inaccurate and defamatory statements about IBCC or its former or current employees.” 

Hsieh and other providers said they are weighing their options as the clinic restructures and patients voice worries during appointments and on social media. 

“We’re definitely the safety net in terms of people getting access to care,” Hsieh said. “[We need to] decide how are we going to amplify our voice and protect the conditions of our work and the well-being of our patients?” 

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