Rendering of the front of the new Open Door health center in Arcata | Image from Open Door Community Health

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Arcata’s new Open Door Community Health Center — the big old building under construction on the corner of Foster and Sunset — is almost complete and, if all goes according to plan, should open its doors to patients this fall.

Open Door announced in the summer of 2019 plans for the project to open by 2022. But when COVID 2020 struck, the project had to be postponed. The crew eventually broke ground in 2021, and Cheyenne Spetzler, Open Door’s senior vice president of development, told Outpost that development has stayed pretty much on schedule since then.

“I just have to say that Pacific Builders, these people are my heroes,” Spetzler said in a telephone interview on Monday afternoon. “Because any time there’s a problem, they just find a way to keep moving.”

At this point, almost all of the most time-consuming infrastructure—the plumbing, electrical, and heating, ventilating, and air conditioning (HVAC)—was installed, and the sheetrock was brought in as well. Spetzler said that one of the main delays in construction was the installation of the windows due to supply chain issues. The crews are still waiting for the windows, which will be delivered around four months late. But Spetzler said that despite the delay, the project’s schedule was not greatly impacted.

The only potential delay that worries Spetzler slightly concerns licensing by the California Department of Health and Human Services. Once the building is complete and passes inspection, Open Door has to turn in its license package, and it sometimes takes months for the state to process it. If everything goes smoothly, Spetzler assumes that the facility will open its doors in October.

To operate the new clinic, operations from the two existing Open Door centers in Arcata – Humboldt Open Door on 10th Street and NorthCountry Clinic on 18th Street – will be transferred to the new facility and the other two locations will be closed. Spetzler said that merging the two clinics will make things more streamlined for both Open Door staff and patients, who often have to go back and forth between clinics. Also, these two buildings were very old and if something catastrophic should happen, the Arcata clinic has no other place to offer services.

The health center building currently under construction as seen from Foster

“The reason for the new building is the precarious nature of the old facilities in which we operate,” said Spetzler. “None of the buildings were ever intended as a clinic. And we did what we could to make them clinics, with lots of exam rooms and funky offices and all. But there were two front desks, two labs, two medical records departments, and two call departments…. It’s not efficient.”

Due to the more efficient operation, the new facility will require fewer staff than the two clinics. But that doesn’t mean there will be layoffs. Open Door has a fairly high turnover rate in some HR departments and often works with staff shortages. Spetzler said any employees at the two Arcata clinics not housed at the new facility will likely be able to transfer to one of Open Door’s other locations in the county.

The new building is much larger than the existing Arcata locations, totaling 34,000 square feet, which is 1,000 square feet larger than the two clinics combined. The space will house 34 examination rooms, one more than the other clinics combined. With a little more space, new facilities and equipment, and a more efficient workflow, the new clinic should be able to accommodate an increased number of patients and annual visits. However, the difference is not huge. Open Door estimates the new clinic will be able to accommodate approximately 14,000 patients, compared to 13,396 currently treated at Arcata Clinics. Visits are also expected to increase from 43,306 to 44,000 per year.

If you’re an open-door patient, you may already know that parking can be a problem at the other Arcata clinics, as each only has 10 on-site parking spaces. The new clinic has almost 100 parking spaces, some with charging stations for electric vehicles, said Spetzler.

Of course, as with all new developments in Arcata, the city wants the facility to discourage driving and encourage other modes of transportation. Spetzler said employees are being offered incentives to use other modes of transportation, including free bus tickets and possibly cash rewards if they don’t drive their cars.

Another feature of the new clinic is a staff gym with showers and changing rooms. Spetzler said that’s a request from many employees so they don’t have to leave the building to train. The availability of showers and changing rooms will also help encourage employees to cycle to work if they are able, as they can clean up and change into work clothes upon arrival.

The new building is also equipped with solar panels and will have backup generators. This means the clinic can serve as an emergency center during major power outages, providing community members with a place to charge their devices, get clean water refills, etc.

Though most of the services offered by the clinic will remain the same, Spetzler said there will be an expansion in behavioral health care, including things like mental health and drug use counseling. Thanks to some funding provided by the Vesper Society of San Francisco, Spetzler said Open Door will focus on offering more of these services, especially for families.

Spetzler said Open Door is also working with the new clinic to expand other services and programs, such as nurse residencies, in the future. She is very excited about the opening of the new clinic and would like to thank the city of Arcata and the community for their support.

“We had these neighborhood meetings and we definitely listened to what the neighbors wanted and we had almost no complaints,” Spetzler said. “There’s actually been a pretty impressive lack of complaints from the neighborhood considering we’re building this huge thing.”

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By Sydney Johnson

Examiner employee author

After a massive decline in HIV services during the pandemic, urban health workers are now trying to find and engage San Franciscans living with the virus.

“We couldn’t offer HIV tests for a while. We had to make sure we weren’t putting participants at risk, especially if they were HIV positive, ”said Juliana DePietro, director of harm reduction services at Glide, a nonprofit that provides homeless services in San Francisco, including free HIV testing.

In 2020, San Francisco saw the average number of monthly HIV tests decreased by an overall 18%, according to a report released Monday by the city’s health department. The biggest drop occurred between March and May 2020, when California was under a protection order but tests still haven’t recovered to pre-pandemic levels.

Community test sites were particularly hard hit, violating one of San Francisco’s primary means of bringing HIV treatment to people who were homeless. The average number of monthly HIV screenings in smaller hyperlocal clinics in 2020 was 44% below the monthly average of 2019.

Tenderloin-based Glide has been slowly working to resume its HIV testing services since employees and customers were able to get vaccinated against COVID-19. But reopening doors is only half the battle – especially for smaller clinics with scarce resources across the city.

The task now is to expand HIV health care to those who did not receive adequate benefits during the pandemic, a fate that has mainly been hit by the homeless.

So far, this has required a mix of resuming pre-pandemic practices, such as sending health workers out onto the streets of San Francisco to provide direct assistance, Pietro said. It also includes searching through old patient records that have been disconnected from the pandemic, making cold calls, and even sending out people with addresses on record to let them know the services are back.

Some community health clinics also work with the San Francisco Department of Public Health to provide on-site HIV testing for people living in hotel accommodations. Proponents say it has been a critical lifeline in reaching some of the city’s most vulnerable populations and keeping up with HIV treatment during the COVID-19 crisis.

But this option, too, is now threatened. San Francisco has already closed four of its 25 on-site shelters, and officials said there could be more closings in the following weeks despite the continued surge in the Delta variant.

“The hotels with on-site accommodation are imperfect, but they have created important accommodation especially for people infected or at risk of HIV. A safe place allows us to get in touch with them, ”said Pietro.

Even after schools, stadiums, and other businesses have reopened, HIV testing has yet to recover. Compared to 2019, the monthly average number of HIV tests was 45% lower in March 2021, the report shows.

“This means that some San Franciscans may have had a delay in determining their HIV status or may not yet be aware that they are living with HIV,” said San Francisco Health Director Dr. Grant Colfax.

One solution the health department has offered is free HIV testing through a program called Take Me Home, which sends test kits to a person’s home. The program was piloted from March to December 2020, with 204 people performing 324 home tests, according to the department’s report.

But aside from April 2020, when 81 participants used the home kits, overall usage declined after July 2020 while HIV services were limited in most community clinics and telemedicine remained inaccessible to those with no access to computers.

“I was really concerned when we saw a massive drop in HIV testing. All of these doctors I know talked about it, but nobody did much to bring it back to pre-pandemic levels, even though we couldn’t ignore other public health issues, ”said Monica Gandhi, director of HIV. Infectious Diseases and Global Medicine at UCSF.

At the Mission Neighborhood Health Center, HIV testing decreased 44% in 2020. The center is now preparing to resume public relations, such as going to local bars and spreading the news about HIV testing and care options nearby.

However, a full recovery will take time as the clinic’s HIV prevention staff tasked with working on Covid-19 tests and treatments will focus on the Delta variant.

“These people are doing both jobs now, but their focus is still really on COVID. We have a great demand for vaccines and tests. In Mission, we are the epicenter of the COVID pandemic in San Francisco, ”said Fernando Gomez-Benitez, deputy director and chief administrative officer, Mission Neighborhood Health.

For a city that has made great strides in fighting HIV, San Francisco health workers are now looking for ways to continue that advance while prioritizing work and resources for COVID-19 testing and vaccination.

“At the moment, many smaller clinics are still closed,” said Reina Hernandez, associate director of the San Francisco AIDS Foundation. “We saw people drop out of care completely because the clinic they were connected to couldn’t see them.”

Allocating more resources to the city’s hyperlocal HIV testing and treatment programs to further combat Covid and pre-existing health issues will be essential to recovery from the San Francisco pandemic, Gandhi said.

“There are people in this city with HIV who weren’t diagnosed last year,” she said. “I hope we can find them by expanding our community-based programs.”

sjohnson@sfexaminer.com

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