June 3, 2005

Hispanic Bush appointee looks ahead

San Ysidro Health Center chief to attend White House conference

By Kelley Dupuis

Ed Martinez, since 1998 the head of one of the county’s busiest health-care facilities, could best be described these days as a man with a lot on his plate.

The San Ysidro Health Center, of which Martinez is CEO, is preparing to start a multimillion dollar building project. And now, Martinez has been selected by President Bush to serve on the advisory committee for the 2005 White House Conference on Aging, scheduled to meet in December.

Martinez is one of 22 people from across the country chosen to serve on the advisory committee. The conference is held every 10 years. He said he expects Social Security reform to be a big topic of discussion.

“There are a lot of concerns about the financial reform, how the reform is going to affect the retirement of seniors,” he said. “You have to look at long-term trends and the viability of the program. It definitely will be discussed.”

Martinez said he expects the conference on aging to be “a great learning opportunity.”

“Each of the 22 members of the advisory committee will bring to the table a certain area of expertise and experience in working with the elderly,” he said. “I’m always looking for new ways to improve our services to our patients.”

As for the area of expertise that he himself will bring to the table, Martinez has a regional perspective that may be unique. The San Ysidro Health Center sits right on the border between the U.S. and Mexico, and nearly 90 percent of the center’s patients are elderly Latinos. As a demographic group, Martinez said, elderly Latinos have problems all their own.

“I think Latinos have some unique problems that are not similar to the general aging population,” he said. “There is not a lot of research into this area, but some studies show that among Latino elderly and adults, there is a lower utilization of services and programs that are available to them.”

The language barrier can be a problem, obviously, but Martinez sees other factors as well contributing to elderly Latinos being under-served in health care.

“Lack of insurance is a major barrier,” he said, “and lack of cash to purchase certain services.”

But it isn’t only a question of insurance and money. Martinez sees a cultural side to the problem as well, with a need for health-care providers to be bicultural as well as bilingual.

“There is a lack of culturally-proficient services,” he said. “If an elderly person can’t communicate with someone who provides a service, and doesn’t feel comfortable or safe, they are not going to use that program.”

For those and other reasons, Martinez said there is a problem with seniors, and especially Hispanic seniors, not seeking health care early enough to head off serious problems.

“Many of our seniors enter health care once they have a chronic condition that’s progressed to the point where it’s placing them at risk,” he said. “With diabetes, for example, many symptoms of diabetes start early and don’t appear serious or acute, so they just go undetected and untreated. And because of this lower utilization of service, elderly patients sometimes wait until they have serious complications.”

And, despite being part of a unique border community, Martinez also said he sees Hispanic seniors wrestling with many of the same challenges that seniors generally have to live with.

“Many elderly people, when they go into retirement, only have social security,” he said. “Those that might need caregivers at certain parts of the day might not be able to afford that, and they want to be independent and maintain their own housing, but sometimes they need help to do that. The resources are limited and, in some areas, diminishing.”

When Martinez returns from the Washington, D.C. conference in December, he will resume work on the San Ysidro Health Center’s most ambitious project in recent years: a 25,000 square-foot expansion of the center. The blueprint calls for a two-story facility specifically dedicated to maternal and child health.

“We’re going to do pediatrics, pre-natal care, obstetrics and WIC, [Women, Infants and Children.] and we’ll also have a nutritional program, and pediatric dentistry, which is a difficult service to access for most people.”

Martinez said the proposed center is built around a unique approach, that of providing a comprehensive health care program for families which will be centered around prevention and healthy lifestyles. Groundbreaking is expected around the time Martinez goes to Washington for the conference on aging – November or December. The cost of the new facility is estimated at $9.5 million, with about $7 million raised so far.

With the need to raise another $2.5 million, Martinez said he has been going around to the business community and various foundations, pitching the program and asking for financial support. One of the biggest contributors so far has been the First Five Commission, affiliated with but separate from the County of San Diego, which uses tobacco tax funds. The commission award-ed the project $5.4 million in 2004.

“They liked the concept of maternal child health and liked the way the programs are going to be working together in an integrated fashion,” he said.

In addition, Martinez said, County Supervisor Greg Cox has helped procure $100,000 over a two-year period, and Congressman Bob Filner has helped get the building project a federal grant for another $400,000.

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