Alison Roberts doing an ultrasound on Kwanjir Pupairoj at Lifelong Medical Care clinic. Photos: Frances Dinkelspiel

The pain in Gordon Loncz’s mouth one Friday afternoon in February was intense. A tooth was so tender that touching it sent spasms through his mouth. The filling had fallen out, leaving Loncz’s root exposed.

It had been three years since Loncz had seen the dentist; his last cleaning had been in 2009 before the state of California cut Medi-Cal funding for dental work. But Loncz, a disabled senior who lives in north Berkeley, knew he had to take action. And he knew where to turn: the dental clinic at LifeLong Medical Care.

For the last 36 years, LifeLong Medical Care has been providing high-quality medical, dental, and other services to Berkeley’s most vulnerable residents. Started by the Gray Panthers as the Over 60 Health Clinic in 1976, LifeLong has now grown into nine different facilities around the Bay Area, with most centered in northern Alameda County.

With a staff of 100 doctors, dentists, nurses, psychiatrists, social workers, and midwives, and headed by Executive Director Marty Lynch and Chief Medical Officer Dr. Barbara Towner, LLMC provides healthcare to more than 22,000 patients each year. Yet the clinic’s mission has remained the same: that all people have the right to receive the healthcare and support they need.

“LifeLong Medical Care has been our partner in community health for decades as a safety-net provider for the uninsured,” said Dr. Janet Berreman, the head of the Berkeley’s Public Health Division. “They have provided expanding health services to Berkeley residents throughout that time, working with us on issues of healthy eating, chronic disease, youth and senior health, and the challenges of income and health disparities.”

When changes to the healthcare laws take effect in 2014, LifeLong will have to accommodate thousands more patients every year. To meet the demand, Lifelong is expanding its clinic at 2031 Sixth Street, a structure designed in 1927 by the architect Walter Ratcliff. A former day care center that once belonged to the school district, the building sits in a west Berkeley neighborhood with the lowest median income in the city. Thirty-two percent of the children living around the clinic live in poverty.

Work started in late February on a $13 million remodel of the historic building, which includes the construction of a three-story high addition.

Construction work has begun on LifeLong Medical Care’s Sixth Street clinic
Construction work has begun on LifeLong Medical Care’s Sixth Street clinic

When completed in late 2013, the new facility will have 27 exam rooms and will accommodate 10,000 patients a year, up from 6,000. There will be a teaching kitchen where clients can learn how to cook healthy meals from local chefs, such as those from Kitchen on Fire and the Ecology Center. There will be meeting rooms where groups of patients can come together to talk about their pregnancies, how to manage their diabetes, or how to quit smoking.

Most importantly, the new building will not have the standard side-by-side exam rooms seen in most medical offices. Instead, the rooms will be clustered in pods so LifeLong can deliver integrated care to its patients. When a doctor determines a patient needs some mental health or social services, he or she can just exit the exam room, pop into a room next door, and immediately introduce the patient to a therapist or social worker. If patient needs his or her blood drawn, there is a Quest blood center right on site. It’s all part of LifeLong’s holistic approach to medicine – treating the entire patient, not just his or her physical symptoms.

Lifelong Medical Care staff measure a patient’s blood pressure
Lifelong Medical Care staff measure a patient’s blood pressure

That’s particularly important for many of LifeLong’s patients who are among the poorest in the Bay Area. Many are working but do not have health insurance. Others are immigrants and are just learning how to navigate this country’s medical system. A large number are homeless. Lifelong staff estimate that two-thirds of its patients live below the poverty line. This means that many of LifeLong’s clients have not seen a doctor in years. They come to the clinic with multiple illnesses, like diabetes and hypertension.

“Poor patients typically have far greater needs than middle class patients,” said Lillian Samuel, LifeLong’s development director. “They have issues with transportation, paying for their medicine, scheduling appointments.”

Anjali Aggarwal, 30, arrived from India in 2004 and when she found out she was pregnant with her third child, she went to LifeLong Medical Care for prenatal care. She used to have Kaiser insurance through her employer, but it was eliminated. Medi-Cal is now paying for her pregnancy care.

Aggarwal was suffering with sciatic pain from the pregnancy and couldn’t move easily, she said. A nurse practitioner at LifeLong referred her to a physical therapist who eliminated the pain. Aggarwal was then sent to a “centering class” for pregnant women. The monthly class, one of dozens of group classes offered by LifeLong, brings women together to talk about their changing bodies, their moods, and what to expect during pregnancy. Recently, the group took a tour of Alta Bates Hospital to become familiar with the place where the women will deliver.

“It’s more like a group appointment,” said Aggarwal. “All the other women you can talk to about your condition, about what your are feeling.”

The centering classes help reduce the isolation many feel. But it is not always easy to convince a patient to be so public about their health conditions. On a recent weekday, midwife Alison Roberts was doing an ultrasound of Kwanjir Pupairoj’s stomach. As Roberts slathered gel on her belly and began to move the device that detected the baby’s heartbeat, she casually talked to Pupairoj about the pregnancy centering class.

“Are you going to go to one of the groups?” asked Roberts.

“I’m not into it,” said Pupairoj.

“It’s okay to go and just listen,” said Roberts.

When Pupairooj heard that, she agreed to attend at least one session.

These classes “provide a social center for people who are isolated,” said Dr. Ron Adler, a gastroenterologist who sits on the board of directors of LifeLong. Participants “learn a lot of tricks from one another. They understand they are not unique, that others have these problems too.”

Claire Isaacs Wahrhaftig always went to private doctors when she lived in San Francisco, but when she moved to Berkeley, after she retired, she started to attend LifeLong’s Over 60 Health Clinic. Even though she could afford to go anywhere, Wahrhaftig has chosen LifeLong because she thinks the care is excellent.

“The doctors are so patient,” said Wahrhaftig, 69. “It’s so rare in this day and age. My doctor doesn’t seem to measure time by the watch. It’s not that requisite seven and a half minute appointment that the insurance companies say it should be.”

When she goes to the Over 60 Health Clinic, there are always places to sit and the receptionist is good about telling her how long her wait will be. Exams are thorough. Wahrhaftig has diabetes, which puts her at risk for losing her eyesight and her toes. At her visits, she usually gets her blood pressure and blood sugar checked. LifeLong sent her to a podiatrist and she got the best eye exam she has ever received from students from the UC Berkeley School of Optometry, she said. She even received free glasses.

“It’s a very senior-friendly place,” said Wahrhaftig. “There are so many ways in which they help the community of older people.”

The care at LifeLong would not be possible without the large cadre of doctors, dentists, nurses, midwives, and other medical professionals who work there, according to Samuel. All of them work part-time, but all of them could be earning more money in private practice.

Dr. Shirley Livingston with her patient, Gordon Loncz

Dr. Shirley Livingston, the head of dental clinic, located on Alcatraz Avenue near Adeline Street in Berkeley, said she feels committed to working with needy patients. Many of them have to juggle the rent, car and gas payments, utility and grocery bills each month. Getting to the dentist is often a low priority because they don’t have insurance and can’t afford to pay $2,000 for a new crown or filling. So they delay getting their teeth cleaned, which often means small problems become big ones.

“Our clinic is here for the under- served patients who cannot afford to go to the private sector,” said Dr. Livingston.

In mid-February on a busy day at the clinic, Dr. Livingston was worried about Gordon Loncz.

“He has three teeth that are hurting him and that I am really concerned about,” she said.

He hadn’t been to the clinic for three years. He didn’t have any insurance. The state will pay for tooth extractions, but not for root canal and Dr. Livingston was trying to figure out how she could treat him.

“They’re extremely conscientious,” said Loncz. “They are interested in saving your teeth rather than yanking them out.”

While many low-income people know about LifeLong Medical Care, it is not well-known in the broader community, according to Dr. Adler. And that has presented some fundraising challenges.

“Rich people don’t know where poor people get their care,” he said. “They assume they go to emergency room.”

LifeLong is working to change that. The clinic has recently joined the Berkeley Chamber of Commerce and started to visit social clubs around Berkeley to get its message out, said Roberta Brooks, the chair of LifeLong’s capital campaign and former district director for Congressman Ron Dellums and Congresswoman Barbara Lee. LifeLong is financing the bulk of the expansion of its West Berkeley clinic but has to raise millions. It has raised $1.7 million so far, said Brooks.

“If people know about LifeLong there is a lot of interest – and we have gotten some extremely generous donations,” said Brooks. “My sense is it is easier to raise money for the symphony and the theater because people who have money use these things.”

Lifelong held its annual fundraiser on Saturday March 3 at HS Lordships at the Berkeley marina. Called “Crab & Cocktails,” the honorary chair was Rita Moreno.  Sedge Thomson of the radio show West Coast Live! was the MC. Julie Sinai, the former chief of staff for Mayor Tom Bates, was awarded the Bobbie Singer award. The event raised about $80,000 for LifeLong’s annual fund, according to Janice Edwards, LifeLong’s communications manager.

“LifeLong Medical Care has been an indispensable partner to the City of Berkeley in providing a full range of health services,” said Mayor Tom Bates. “They have grown and flowered into the primary care giver for the public patients in the entire East Bay. We are delighted to see them expanding their primary care facility at 6th and University Ave. It will more than double ability to serve their Berkeley patients and be the latest in their family of community health facilities.”

LifeLong Medical Care has nine facilities throughout the Bay Area:

Primary Health Care

LifeLong Over 60 Health Clinic
3260 Sacramento St., Berkeley

LifeLong Berkeley Primary Care
2001 Dwight Way, room 1363, Berkeley

LifeLong West Berkeley Family Practice
2031 Sixth Street, Berkeley

LifeLong Downtown Oakland
616 16th Street, Oakland

LifeLong East Oakland
10700 MacArthur Boulevard, Oakland

LifeLong Howard Daniel Clinic
9933 MacArthur Boulevard, Oakland

Dental Services

LifeLong Dental Care
1860 Alcatraz Avenue, Berkeley

Adult Day Health Centers

10700 MacArthur Boulevard, Oakland

1905 Novato Boulevard, Novato

The clinic also runs a mobile dental clinic for the homeless, and provides medical services in some select Berkeley schools.

Frances Dinkelspiel, Berkeleyside and CItyside co-founder, is a journalist and author. Her first book, Towers of Gold: How One Jewish Immigrant Named Isaias Hellman Created California, published in November...