Growing Farm Worker Clinic Fears State Cuts : Medicine: The 21-year-old, Oxnard-based Clinicas del Camino Real celebrates the opening of a new office.

Guadalupe and Augustine Toscano have been worried about the arrival of their first baby. So when the expectant couple consulted an aunt, she suggested that they go to an Oxnard clinic where almost all the workers speak Spanish.

“We had another doctor, but we couldn’t communicate our concerns to her,” Augustine Toscano, 23, said in Spanish as he waited for his wife to be examined by a bilingual doctor at Clinica de le Communidad de Oxnard, one of three clinics run by the Oxnard-based Clinicas del Camino Real.

The Toscanos are two of the estimated 23,000 people who received the group’s prenatal, pediatric and mental-health care last year.

Started at a strip mall 21 years ago, Clinicas del Camino Real has become the largest and fastest-growing network of primary health-care centers for migrant workers in Ventura County.

“We’ve grown in the last few years by 150% in terms of patient load, staff and budget,” said Executive Director Roberto S. Juarez.

Last month, the organization opened a 16,131-square-foot building at 650 Meta St. in Oxnard. Today, clinic workers will celebrate their new $1.8-million facility with a special ceremony at 4 p.m.

The organization also operates clinics in Saticoy and Fillmore, and later this month, it will open a new office in Ojai.

Before the first Oxnard clinic opened in 1971 in a 900-square-foot office at a strip mall on Saviers Road, workers had to go to Ventura County Medical Center for medical care from a bilingual physician, Juarez said.

Although that option still exists, Clinicas offered bilingual medical care closer to home, Juarez said. Its fees are based on a sliding scale, and about half of the patients are on Medi-Cal, he said.

In 1986, the clinic moved into a 2,700-square-foot office on B Street, where it stayed for six years, until the Meta Street location was built. Today, the clinic employs about 80 workers.

Before the new office opened, patients had to wait up to four weeks for an appointment. That time has been cut in half, Juarez said.

There are 14 examination and treatment rooms at the new clinic, contrasted with five at the old site, and the facility has added a dental program. The clinic has also doubled the space used for mental-health counseling from a half to a whole room.

“In the past, the psychologists would hand-wrestle for it,” Juarez said. “When they didn’t fight for it, the doctors wanted it.”

Because of the growth in patients, Clinicas faces a financial battle to stay open, Juarez said.

The budget news out of Sacramento strongly suggests that the clinic will lose $650,000 in rural health funds from its $3.3-million operating budget. And it is already running $300,000 in the red.

“It couldn’t come at a worse time,” Juarez said. “We’re running a deficit, there’s work we haven’t been paid for and then we’re facing cuts in our Medi-Cal. This whole thing is built on a house of cards. If the state money goes, the feds will pull their money.”

County health officials said the cutbacks would cause hardship for many migrant workers in the county, who number about 60,000 according to the federal Department of Health and Human Services.

Juarez said a large part of Clinicas del Camino Real’s efforts is directed at obstetrical care and family planning.

About 3% of the 11,000 women who delivered babies in the county in 1990 had no prenatal care, and 13% visited a doctor only one to four times before giving birth, said Dr. Richard Ashby, director of physician services at Ventura County Medical Center.

Clinicas runs weekly prenatal programs at its three facilities. County officials in the Public Health Department praise Clinicas’ efforts in obstetrics and other areas.

Four years ago, Clinicas started an AIDS-prevention program directed at farm workers, called “ Uno a Uno ,” or “One to One.” It is the only such program in the county.

“One thing they’ve done is get AIDS educators out in the fields where people are,” said Dr. Larry Dodds, who heads the county’s Public Health Department. “We’ve had difficulty hiring people to do that kind of thing. They can reach out (to) people who may not otherwise have access to any other health care.”

Despite problems in funding, Juarez said, he hopes that the clinic will remain open without layoffs and loss of services.

“We want to see the most needy population,” he said. “We’re optimistic.”