When SharpHealth Care opened its Downtown Senior Health Center just over four years ago, it was modeled on the successful Clairemont Sharp Senior Health Center-Genesee. Almost immediately, the Downtown staff found its patient population to be “very, very different,” says Jeanne Binder, nursing manager of both centers.

“The common denominator was that patients were all seniors on Medicare,” she says. But from there, the groups served had very little in common.

Many Downtown seniors live in single room occupancy (SRO) hotels or subsidized senior housing. Others are homeless or nearly homeless, meaning they are a rent check away. Still more are a poor fit in their environment, perhaps alienated from family and with physical or mental health problems.

They could go to other clinics, but not one that serviced only older residents (in this case 60 and over or disabled) and addressed their specific problems and conditions. They were not used to comprehensive treatment in one place for physical, mental or emotional difficulties or a clinic near their home or a senior center.

“It was a grass roots effort,” Binder says. “We had a ‘Field of Dreams’ vision: ‘Build it and they will come.’ It was not that easy.”

Staff members were diligent in trying to reach Downtown seniors and earn their trust with events like free flu clinics and other activities aimed at convincing seniors they could get medical treatment and advocacy for other needed services.

Those efforts paid off. Now into its fifth year at 926 10th Ave., the clinic professionals — two internists, two psychologists, a podiatrist, an RN case manager, a nurse practitioner, two licensed vocational nurses, a social worker, a dietitian, clerical staff and Binder — see about 250 patients each month and the number keeps climbing.

Success in providing services balances precariously each year with budget woes. The clinic opened in February 2001 with a $313,000 Community Development Block Grant, additional funding through Sharp and donors to Sharp HealthCare Foundation. Many of its services are reimbursed by Medicare and others by MediCal, but that is far short of what it costs to keep the center afloat.

With an annual budget in the neighborhood of $500,000, the Downtown center faces a shortfall of $240,000 as it is challenged by additional patient visits, more providers, community and clinical education and harm reduction programs and more services, including some that are not reimbursed in any way: patient transportation, care coordination, access to low-cost medications and medication management.

Enter Sharp HealthCare Foundation Friends of the Downtown Senior Center, a volunteer group headed by Kay Porter, a Downtown resident and member of the San Diego Foundation board. “Our first impulse was to help the center any way we could,” says Porter, “but our main focus so far has been to acquaint everyone with it.”

The original approach to reach the seniors who need the services and for the health workers themselves to understand the unique clientele living Downtown, is changing. “Now we are spreading out — to Downtown organizations like San Diego Partnership, CCDC and businesses. Now we will go to Downtown residents, and eventually we will be doing fund-raising,” says Porter.

The giving already has begun. The Legler-Benbough Foundation gave the health center a vehicle to get seniors to and from the clinic and other appointments. Porter credits Mervyn’s, Target and Ralphs for generous donations of clothing, bedding, food and other items.

The Friends plan to meet every two months on the third Monday for a sandwich lunch. Those interested in the group, or in seeing the clinic, should call Porter for scheduling. She can be reached at (619) 236-8038.

— Sandy Pasqua