SCV NEWSMAKER OF THE WEEK:
Cheryl Laymon
Executive Director,
Samuel Dixon Family Health Center

Interview by Leon Worden
Signal Multimedia Editor

Sunday, January 16, 2005
(Television interview conducted December 8, 2004)

Cheryl Laymon     "Newsmaker of the Week" is presented by the SCV Press Club and Comcast, and hosted by Signal Multimedia Editor Leon Worden. The program premieres every Wednesday at 9:30 p.m. on SCVTV Channel 20, repeating Sundays at 8:30 a.m.
    This week's newsmaker is Cheryl Laymon, executive director of the Samuel Dixon Family Health Center in Val Verde and Canyon Country. The interview was conducted Dec. 8. Questions are paraphrased and some answers may be abbreviated for length.

Signal: Samuel Dixon Family Health Center — one center, two locations?

Laymon: It's "Center, Inc.," but we have two locations, so we say, Samuel Dixon Family Health Center — the Val Verde clinic or the Canyon Country clinic, to distinguish. We had a big discussion about that, as a matter of fact, when we opened up the Canyon Country clinic...

Signal: How long have you been in Val Verde?

Laymon: The Val Verde (clinic) started under Rev. (Samuel) Dixon over 20 years ago. The clinic as we know it today was incorporated in 1990, and it has been in that location since that time. In the year 2000, we opened the Canyon Country clinic.

Signal: Val Verde in its current form in 1990, Canyon Country in 2000; will it take 10 years to see another one?

Laymon: That's a real interesting question. As a not-for-profit, we are governed by a board of directors and we have a strategic plan, and we've identified a need for services in Newhall.
    Because of the people we tend to serve, which are primarily people without insurance and with limited economic means, we feel that it's in the community's best interest for us to make services physically accessible, geographically accessible, financially accessible, language-accessible to those people. So, we think, we've got the west end of Santa Clarita covered by Val Verde; we've got the east end covered by Canyon Country; we want to have the southern tier covered at some point in time by a clinic in Newhall, so we (can serve) the community with access on all ends.
    That's the idea. Hopefully this next year, we'll start to see some progress. We have Adele Macpherson as our board president this year, and she has appointed Ed Bolden, who is our vice president, to chair a strategic planning committee to come up with a plan for the clinic in Newhall — what services it will (provide), what kind of design it's going to have, what kind of site are we going to need...

Signal: Do you have some property in mind in Newhall?

Laymon: All of Newhall. No. And that will be the trick. What we want to do is be able to establish something that will be permanent. I don't know whether that's going to mean building or buying or some combination of the above, but no. As far as we've gone at this point, there's a big need in Newhall. We want to be able to reach it. We want to make it easier for people to get services. Therefore, Newhall, but where in Newhall? We don't really know at this point.

Signal: Why would somebody go to Sam Dixon instead of some other doctor?

Laymon: That's a very good question. For people who have insurance — as we all know, today, many people have managed-care insurance. Therefore, their doctor is assigned to them.
    Let's say their policy is through Blue Shield. They'll get their list of doctors, and then they'll take one, and then they really have to go to that doctor for their insurance to cover their care. People who primarily come to Samuel Dixon Family Health Center don't have insurance.
    Other than that, it's exactly the same. You come in — if you're going to have a physical, you need your tetanus shot, you need your cholesterol checked, you have a bad sore that won't heal, you've not been feeling well for a couple of days and you think you'd better get over it and you don't have insurance and you want to make sure it's affordable, come to Samuel Dixon Family Health Center. That's as simple as it is.
    There's a little bit of paperwork that you have to do, because of the fact that we have various funding sources, and our objective is to see — when we look at your family size and your income and what you're needs are, we're saying, what program can we find that's going to make it easier for you to have health care? How can we make it as affordable as possible for you? Therefore we need your incoming information. ... After that, you just go see the doctor, tell him what your concerns are, your needs are, and it's the same as going to any other doctor.

Signal: How do they compare to other providers in terms of quality?

Laymon: Quality-wise they're absolutely the same. All of our providers are licensed — certified by the state of California — and have all the credentials required. We have a medical director who is absolutely wonderful. He's a doctor and he works primarily in Canyon Country, Dr. Brian Downs. Our main provider is Michael Gales, who is a physician's assistant, who's our main provider in Val Verde. In fact, he was in there in the early days when the clinic first started. (He) was one of the first organizers there, and worked with the community to get the clinic started, originally, and (he) is back again.
    So, would you find these fellows somewhere else? Absolutely. There's no difference, There's absolutely no difference in that. ... We try to make the services affordable for somebody. Somebody who's making more money is going to pay more; somebody who's making less money is going to pay less. That's the basic idea.

Signal: You've got a sliding scale.

Laymon: Sliding-fee scale, that's exactly what it's called. That's right.

Signal: Are your doctors and nurses all in-house?

Laymon: Actually, we have an interesting thing. It's important for us, for the concept of continuity of service, to have our own providers. That way, you come in this week, you see Dr. Downs; you'll see him next week. He knows you, he knows your chart, and he knows what's going on with you — as opposed to seeing Dr. "A" this week and Dr. "B" next week and Dr. "C" the third week after that.
    We feel it's important to do that. However, we have been able to benefit from some community resources. Right now, we have a great arrangement with Kaiser Permanente, in that their local office here in Santa Clarita lends us physicians, if you will, one afternoon a week on Thursdays, to come out and provide care for our patients.
    This way, we have access to some other areas of specialty that we don't have on staff, and it also gives us the opportunity, for our more difficult patients, for our doctors to go to them for different opinions. Other than that, it's just our providers.

Signal: Are you geared more toward long-term care than emergency services?

Laymon: Well, I would make a distinction between emergency services and primary care, versus long-term care. Primary care is usually defined as anything that doesn't require a specialist or in-patient care.
    So again, it's just like going to your family doctor, but if you get to the point where you have some sort of an odd heart, or you have some sort of severe thyroid problem where you really need to go to a specialist, that would be where we would try to find a referral for you. Other than that, coming in, your illness, your colds, even the treatment and management of chronic illness, which might be a long-term concept — we have a lot of diabetic patients, we have a lot of cholesterol patients, we have a lot of people with hypertension.
    Hypertension is a real tricky area because nobody knows that they've got it. Because you can't feel it; you can't feel the fact that your blood pressure is, like, sky-high. Sometimes you can feel the medications; that's sometimes worse. And that's why they call hypertension the "silent killer," and that's why it's so important to be on top of your blood pressure numbers and to keep them under control.
    But I would make a distinction in terms of what we do between emergency care and primary care. Emergency care is, you can't breathe, you're unconscious — don't call and make an appointment, please. Call 911 and go straight to Henry Mayo (Newhall Memorial Hospital), and just go straight to the emergency room.

Signal: You're not like First Care. People don't just walk in and expect treatment right away.

Laymon: We're not an urgent-care facility. We're not set up to do that. That requires you to have certain kinds of equipment on board at the location, and certain kinds of specialties available. So we're not, at this point, set up to do that.

Signal: So if somebody wanted to come in for a flu shot or a physical or something like that —

Laymon: Please, yes. And one of the things that's real important in primary care is to keep track of your basic health status. It is important to keep track. Have a physical every couple of years, watch your weight, look at your lifestyle, watch your blood pressure numbers, monitor your cholesterol and pay attention to your family history.
    When you go into the doctor and he asks you all those dumb questions — what did your mother have? and, what did your grandmother have? — it's for a reason. A lot of those things do follow through in the family, so you do kind of need to be aware of that.

Signal: A lot of what you do is preventive medicine?

Laymon: Absolutely. That's the best thing.

Signal: Do you receive federal funding geared toward keeping people from ending up in the hospital?

Laymon: We have access to every single state and federal program that we can get our hands on, from the standpoint that we know that there are uninsured people and people with limited incomes.
    As we know, people — when we don't have a lot of money, we prioritize. You know, you have to have roof over your head, you have to have some food in the refrigerator, and you have to have gas in your car to go to work. And then you kind of cross your fingers., You don't go out and buy health insurance if your employer doesn't give it to you. You kind of cross your fingers and hope for the best. That's really where we come into play, a lot of times.

Signal: You mentioned referrals. Do you work with the patient to find a specialist who will provide service at a low cost?

Laymon: I will say that that's difficult, because a lot of times, to be honest, (with) many of our referrals, we do end up making that referral down to Olive View for specialty care. They're a big county hospital; that's what they're set up to do, and that's where it's also affordable — which, again, is a deterrent for many people. So yes, we'll work with the patient to make sure that referral will follow through, see that he or she gets to where they're supposed to be going, and then monitor the results afterward.

Signal: About your sliding-fee scale for the uninsured — what about people with lousy insurance?

Laymon: A really growing phenomenon is what we call the underinsured. Now, the way we state our mission is: Our mission is to serve the residents of Santa Clarita, especially those that are underserved. We define "underserved" to mean uninsured and underinsured. Because, you're right: That's a really big group of people.
    We know, for instance, in terms of the uninsured, that the 10 highest-growing, fastest-growing jobs in Los Angeles County do not have benefits. We also know that in Santa Clarita, we do have that same percentage as we do in the rest of the county — that is 25 percent. So we know that there are people out there who are not going to routinely be going to the doctor, that are going to be prioritizing other needs ahead of health care, because they do not have health insurance through their employer. Therefore, it becomes really important to have that affordable health care available for them. That's what we really exist to do.
    And then, the second group, which is as big, is people who only have limited health insurance that maybe covers them in terms of a major catastrophe — you get in a car accident or (have) a stroke or something like that — but what about a broken arm, a broken leg, an ear infection? Just things like that. They don't have health insurance that covers them for that. We would like to see them. We are here to help them.

Signal: Will you also serve people who have a fine job and plenty of health insurance?

Laymon: Absolutely. Just think of us as your friendly, neighborhood doctor here in Santa Clarita, because that's really what we're here to do.
    Again, if people have insurance, they will tend to go to a doctor under a particular plan, but we also see people who I would not call "economically disadvantaged" who don't have insurance.
    Small business owners — what you're thinking about, you've got (just) so much money starting your business, and we see a lot of growth in small businesses in this area. That is one of the first things people put off until later — purchasing health insurance for themselves — because they're thinking about their marketing, and they're thinking about their product, and they're thinking about their office and their paper supplies and stuff like that. And they'll say, "Never mind. I'll put off my health insurance until next year when I'm making a profit in my business."

Signal: How many people do you serve, and how big is your staff?

Laymon: Well, first of all, in terms of the number of people we provide services to: Last year, we provided close to 10,000 patient visits in Santa Clarita, and almost all are Santa Clarita residents. Our mission, again, is to serve Santa Clarita; we're not going to turn somebody away if they happen to come from Granada Hills or something like that; but again, the majority of our patients are from Santa Clarita.
    How big our staff is? We have a very small staff. I have to count on my fingers — I think we have 11 full-time equivalents. The one main provider, Michael out in Val Verde (and) three medical assistants; we just hired a new bookkeeper, who's just terrific — Michele Weber; we have a new administrative assistant, part-time, (who) is also terrific. We have Arlene who does our billing. And then we have our Canyon Country, staff which is Sylvia Sanchez, who's our lead medical assistant; Dr. Brian Downs, who works at both clinics but primarily in Canyon Country; and then Laura Valle and Claudia Vasquez. And that's the staff. So it's about an 11-person staff between the two clinics.
    It's really funny because nobody can take a day off during a time when they're assigned to be at the clinic because it's, like, "Oh my gosh, How are we going to do this?" Nobody can get sick. It's a policy we have. And nobody takes time off because we're so thin.

Signal: How do you accommodate people with, say, a low-paying job, who can't leave work during the day to go to the doctor?

Laymon: We know that people in those economic situations — they're going to put off going to the doctor anyway because they fear the cost, but then they're going to lose money if they're not at work. So what we do is, we're open every other Saturday in Val Verde, and then alternate Saturdays in Canyon (Country). So we're open every Saturday, one way or the other. We're open Friday mornings at 7:30 at both clinics, and Wednesday nights until 7 at both clinics; alternate Mondays because of the alternate Saturdays. That's how we try to get some flexibility for those people who are working.

Signal: Who is your average patient? Where, within the SCV, do they live, and what's their economic condition?

Laymon: Our average patient is somebody who is working, and they're at a minimum wage-type job. They probably have a rented apartment with maybe another family living in there. And they can live anywhere.
    This is a very interesting thing that we found out in Santa Clarita. The original design of the Santa Clarita Valley is really nice because we don't have a Watts, we don't have an East L.A., we don't have an impoverished area, really, in Santa Clarita. We have some areas where there are little pockets, and we can even tell they're certain census tracks, but it's funny because almost all the people we serve are what we call the "working poor." They're in that group where they're working, but they're just sort of barely making it. They're from all over the place. Very few patients that we serve aren't working. It's interesting. They're really struggling.

Signal: You mentioned, on staff, a number of Hispanic names. Are you full-service bilingual English-Spanish?

Laymon: Exactly. That has turned out to be really important for us — to have people who speak Spanish be comfortable coming to the doctor. Our staff is very fluent back and forth.

Signal: How did Cheryl Laymon get into this?

Laymon: I've been at not-for-profits my whole working career. I started out — I have a master's (degree) in social work and a master's in business administration. I started about 300 years ago in Wisconsin, working for community services, and ended up going to work of the United Way. (I) worked for the United Way in Milwaukee and Burlington.
    My husband's family is from here; (we) were always headed here. We got to Chicago and instead of turning right, we turned left. And anyway, we eventually we ended up out here, and I worked at a number of different charities. We've lived in Santa Clarita for about 18 years, and it was just sort of a fortuitous thing. I was contacted by one of the board members about eight years ago when the former executive was leaving. They wanted someone to fill in on an interim basis until they decided what they really wanted to do. And I said, that's great. It would be fun. I'd enjoy doing it. And I'm still there.

Signal: Tell us about the origins of the clinic.

Laymon: It goes back to Rev. Dixon, who was a minister at a church in Val Verde. Of course, back then, and even today ... as you well know, many people still don't know where Val Verde is. They think it is — I don't know where they think it is. And truth to tell, you really can't just jump in the car and by accident land in Val Verde. You've got to kind of know where you're going.
    Anyway, it was a little bit even more isolated, or a little more separated, even when Rev. Dixon was there. He decided that he wanted health care for the community, for his parishioners. He sensed this geographical isolation and separateness. ... He was interested in doing that, and he met with some people, and eventually a relationship was formed between Henry Mayo (Newhall Memorial) Hospital here, and Santa Monica Hospital. ... They provided the physicians, the residents; Henry Mayo provided the supplies — and actually, that's when Michael Gales became involved, because he was the coordinator for it.
    Through the years, Rev. Dixon offered this sort of health care actually in a room to the side of his church. And then, as things got more formalized through the years — and I believe he was involved with this the whole way, as they actually started the first clinic at a different (location) than where it is now, on Marvin Avenue.
    My understanding is that as they were getting ready to do all of this, that's when Rev. Dixon was in a car accident, and then the community that was working decided to name the clinic in his memory, and we kind of just went on from there.

Signal: Just like the community of Val Verde, your clinic is sort of a hidden secret. Do you want to drum up more business, or are your hands full with what you've got?

Laymon: We've got plenty to do, but we also know that there are people who need our services and don't know that we're there. So, it is a matter of trying to create that awareness, and as you and I were talking earlier, it's a common fact of life, I guess, that you don't think about where you're going to go the doctor until you actually have that need. If you're working and you're not making a lot of money, you put it off until you can't change your mind anymore. It's that kind of a thing. So we do try to create awareness.
    We work a lot with the other not-for-profits here in Santa Clarita. We try to get things in the newspaper ... as often as we can. (We) just try to keep that word out there. It's a never-ending effort. You've just got to keep doing, keep doing, keep doing, because they won't really think about it until they really need it, and then sometimes that's a problem.
    I'll give you a story of an example. There was a fellow who came in a couple of years ago — this is a story that I remember, that one of the providers told me about — and he had this terrible cut on his leg. It had been bandaged up, but it had gotten infected and the bandage was sticking to it, and it was just awful. So they said to him, "Why didn't you come in?" Because it was hurting him to take the old, rotten bandage off. And he said that he didn't want to leave work. And so he waited until he had no choice.

Signal: Many people who don't see a doctor regularly figure they'll simply go to the hospital emergency room if they get sick or injured. That's not always such a good idea, is it?

Laymon: No. It's not good from the standpoint of the emergency room staff. If they're tied up in situations that really aren't life-threatening, where you don't really need that highly trained, skilled emergency-room nurse and the emergency-room doctor — that could have been handled (by) your primary care doctor. And of course it's not good from the patient's standpoint, because (if) you go into the emergency room and it's not life-threatening, they're going to triage you and you're going to wait behind the life-threatening people. So you could be in a lot of pain, but they know you're going to eventually be OK. They're going to get to you, so you're going to wait.

Signal: Not to mention cost.

Laymon: It really isn't good to do that. It's not a good use of a person's time. It's not a good use of hospital resources.

Signal: For people at the high end of your sliding-fee scale — people for whom cost doesn't matter — how do your costs compare to other providers'?

Laymon: Our costs are still a little bit cheaper because we can do some consolidated purchasing through a cooperative we're a part of. And because we're not-for-profit.

Signal: Do you receive much funding from federal and state sources?

Laymon: I do want to say that we are very grateful to the Santa Clarita community for the support that we get. We have our little "Rubber Ducky Regatta" (fund-raiser), which has been chaired by Bob Hudson at the hospital and Roger Schnurr from Union Bank, which is just a funny and fun event. That has been a great fund-raiser for us. And now, on Jan. 22, we'll be the beneficiary for the Elks Lodge roast, and where Bob Hudson — poor Bob Hudson — I'm sure that's going to be a hilarious night.
    Quality of care, I will match us against absolutely anybody. Prices, we are going to be reasonable — and more reasonable, probably, than just a regular private clinic that doesn't have access to some of the funds that we have.

Signal: Do you have the flu vaccine?

Laymon: We have a limited supply. I should thank (The Signal) for helping last year, when we had a supply and then we ran out right away. We had those special sessions planned. We were going to hurry up and get the flu shots out to the people. We had one of them and we ran out of flu vaccine.
    Well, this year was a whole different ball game because of the crisis overseas and everything with getting the supply. We have a very limited supply right now. It is strictly for the really high-priority people — people with chronic illness, people over 65, and children. So, if you have access to your insurance provider, call him or her and see if they've got it. If not, call us and just see if you qualify as one of the high-priority groups. Unfortunately, that's all we've got at this point.

Signal: There have been reports that there might be an ample supply in the next few months. What have you heard?

Laymon: I just heard that myself, too. I have not received any official communication that we are going to be able to get any, at this point. ... I do not know for sure...

Signal: Where do people call you?

Laymon: Val Verde is 257-4008. Canyon Country is 424-1220.
    The Val Verde clinic is located at 30257 San Martinez Road; the Canyon Country clinic is located at 27225 Camp Plenty Road.

    See this interview in its entirety today at 8:30 a.m., and watch for another "Newsmaker of the Week" on Wednesday at 9:30 p.m. on SCVTV Channel 20, available to Comcast and Time Warner Cable subscribers throughout the Santa Clarita Valley.


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