MODESTO — Running a small nonprofit is always a challenge in a tight economy.
In November 2011, Modesto's DMC Foundation nearly closed its Miller's Place adult day health care and Alzheimer's day care programs because the state considered eliminating the funding.
Now, the money's there, but the inability to get to it in a timely fashion once again leaves the nonprofit facing possible closure, this time April 12.
Why? Let them count the ways:
The state paid MediCal benefits directly to the foundation, which provides day care to disabled and medically impaired adults. Then the rules changed. Now, participants must belong to either the HealthNet or Health Plan of San Joaquin insurance plans, which pay the $76 per day, per adult day health care client and then bill the state for reimbursement.
The problem with having middlemen is that they pay the foundation monthly whereas the state paid weekly, said Victor Montes, the agency's acting executive director while Executive Director Tom Truax is out on extended medical leave.
The transition from the state's direct MediCal payments to the contract providers created a slower cash flow. It caused the foundation to fall $80,000 in debt and two months behind on its payroll taxes, Montes said.
Pam Chavez, the foundation's operations officer, still is trying to get more than $25,000 due from Anthem (Blue Cross), which no longer covers the adult day health care clients. Chavez said Anthem, beaten out by Health Plan of San Joaquin during the bidding process, isn't exactly rushing over a Brinks truck to pay what it owes.
"We think they'll pay, but there's not much incentive," she said.
As part of the transition, the state told clients to choose one of the two insurers or it would pick one for them. Many of the clients' spouses confused or intimidated by the changing process didn't fill out the paperwork properly, on time or at all. But the state didn't impose a choice, Montes said, and now Miller's Place is out $20,000 in reimbursements.
"We've been squeaking by the last two years anyway, and now this," Montes said.
Leave it to the criminal element to make its mark as well. Vandals and thieves struck the facility repeatedly over the past couple of years. They stripped copper wire, destroying several of the air conditioning units. They severely damaged the agency's lift-equipped van. The foundation's share of repairs surpassed $35,000, and that doesn't include three recently vandalized AC units it can't afford to repair.
And finally, it didn't help that the Alzheimer's Aid Society of Northern California which paid $1,900 a month and a year in advance to rent space from DMC Foundation ceased operations in February.
The departure also left a void in services. Cindy DenBrave, who worked with the organization, is among those who created the Alzheimer's-Dementia Support Center and are awaiting confirmation of their nonprofit status. They are renting the same space from the foundation two days a week and hope to become a full-time tenant next month.
"We're hitting up caregivers, friends and relatives for funding," DenBrave said. "We just haven't had a chance to get out in the community yet."
Each Monday, 35 to 50 caregivers come for training and support. Some bring their loved ones along for music, arts and conversation with an activity director while in their own sessions. They've added a session Wednesdays in Turlock and Thursdays back in Modesto.
Miller's Place benefits because it receives referrals from the new group. Even so, the loss of income has hurt the foundation's bottom line.
Consequently, if some generous groups or individuals don't come to the rescue and in a hurry the DMC Foundation will shut down April 12, putting 49 full- and part-time employees out of work. Scores of adults who receive the services will have no similar program available. The adult day health care program is the only one of its kind serving Stanislaus, San Joaquin and Tuolumne counties.
The Alzheimer's day care facility for which the clients' families pay $35 per day privately is the only one available in a five-county area, Montes said.
The cry for help from the community is necessary on three fronts, he said. First, it's the hope that the money will come in to right the ship. Second, he feels an obligation to the participants, whose families will need to find other arrangements for their care if it closes. And the employees, too, need the opportunity to consider other job opportunities.
"We want to do the right thing," he said.
If the DMC Foundation survives this latest turmoil, he said, it will be nothing short of a miracle. As many as 40 similar programs throughout the state have closed over the past year, he said.
"No doubt, the transition led to that," Montes said. "We do have hope, and we're going to give it our best."
Jeff Jardine's column appears Sundays, Tuesdays and Thursdays in Local News. He can be reached at firstname.lastname@example.org, @jeffjardine57 on Twitter or at (209) 578-2383.
GETTING IN TOUCH
Contact the DMC Foundation at (209) 527-3412 or go to www.dmcf.org.
Contact the Alzheimer's- Dementia Support Center at (209) 577-0018.