FORT BRAGG — Specialized healthcare — which is any care that differs from seeing a primary doctor — is an option some are struggling to obtain on the coast during the Coronavirus. Access and options for healthcare, especially reproductive care, are crucial to delivering long-term healthcare to locals. Stacy Pollina-Millen, Reproductive Health Program Manager at Mendocino Coast Clinics, weighed in on the lack of specialty care in coastal Mendocino County.
“I feel that we live in an under-served community where we don’t have a lot of resources or specialists,” she said. “[Over the past 25 years] we have grown and developed and come to a point where we offer a great range of comprehensive services.”
Pollina-Millen said the clinic offers specialized services to coastal residents, including women’s healthcare and reproductive health.
“We provide a whole range of women’s health services,” she said. “Regular well-women visits, annual check-ins, Pap tests and just take care of women as part of their regular healthcare.” Other services include consults, colposcopy, cryotherapy and cyrosurgery.
“The other big piece is that we provide contraception, so we provide both regular, clinic-based care,” Pollina-Millen said. “We also have a walk-in clinic called ‘Blue Door.’”
Blue Door at MCC provides services to youth up to age 25, including birth control prescriptions and a text-based service to answer health questions.
“We have an open door and people come in and can get any kind of birth control,” she said. “We provide all kinds of birth control on-site: We do three kinds of IUDs, we also do Nexplanon, which is the implant.”
Pollina-Millen also detailed the way Blue Door’s operations have changed since the pandemic began.
“At our site — sexual and reproductive health/Blue Door — we have more of a hybrid model,” she said. “When possible, we do our visits virtually, video or phone, however, many of our patients need to be seen in-person. We are seeing our OB patients in person, as well as providing Depo, IUD inserts and Nexplanon. We continue to offer STI testing and Well Woman Visits as needed.”
Before someone comes in for any kind of procedure, Pollina-Millen said, they come in and meet with the provider and talk to the provider first.
“The first visit in the consult is a conversation with the patient, there’s not even an exam that we do. Basically, talk about the pros and cons of any procedure that we’re doing, any device that someone’s going to decide to have put in their body.”
She then established that the patient would have the option of seeing either a male or female healthcare provider for the procedure.
Transportation is also a factor in getting coastal residents the health services they need, and with the closure of the maternity ward at Adventist Health – Mendocino Coast Hospital earlier this year, women seeking obstetrics care now have to travel to Ukiah or further afield.
“When there is something that we don’t provide that a patient wants, wants to be referred or needs to go somewhere else, needs to go to Ukiah or even UCSF, we refer patients and we help them access care that they need out of the community,” Pollina-Millen said. “And that’s true not just for women’s health; that’s true for a cardiologist or a urologist or any of our patients who need referrals because we don’t have specialists in the community.”
Inclusivity is also something the clinic has been mindful of in providing access to a wide array of patients. The clinic provides bilingual services, resources for accessing health insurance options, an LGBTQ-focused sexual health program called Open Door, and reproductive healthcare that extends to both women and men.
“When a young man is growing up, you go to the pediatrician, you go there for the doctor, and then all of a sudden there’s not a place for their healthcare if they’re well,” she explained. “For women, it’s sort of a given that you go get your Pap, you go do this, and if a woman’s on birth control, she has her GYN provider.”
With the only local maternity and labor ward now closed for good, Pollina-Millen says her clinic provides services for expectant mothers up to their third trimester, where they are then referred to out-of-town practices. Her prerogative is to bring families — and ultimately, specialized healthcare — closer to home.
“If people are leaving the community to give birth, [I] definitely want to encourage them to get back and get care directly in their community,” she said, “which is easier if you have a newborn than driving an hour and a half over Highway 20.”