The founding director of an Oklahoma City medical clinic who sparked Jackson Higginbottom’s passion for public health died suddenly on December 23, 2022, and the clinic was in danger of closing for lack of funds. In an instant, Higginbottom, MPH ’20 (Social and Behavioral Sciences), was thrust into the position of running the clinic and trying to save it – all while working full-time in New Haven, Connecticut.
Despite what has been one of the most challenging times in his life, Higginbottom has found room for guarded optimism.
“I’m hoping to find four to six months of funding to buy the clinic time to really evaluate its work and be more competitive for grant funding,” he said. “I submitted my first grant application as the president of Manos Juntas [in mid-February]! Together, our new officers are excited to lead our organization into a new era of growth and impact to serve the people of Oklahoma.”
Higginbottom’s effort is that much more impressive when you consider he already has a full plate working in New Haven. He’s a program administrator for the Community Alliance for Research & Engagement (CARE), a collaboration between the Yale School of Public Health and Southern Connecticut State University that seeks solutions to health problems through community-based research, and at the Yale-Griffin Prevention Research Center. But when Dr. Boyd Shook, co-founder/director of Manos Juntas, passed away, Higginbottom found himself having to shift gears to save the clinic, where he began volunteering in 2014 as a pre-med biology student.
“Dr. Shook was the reason I decided to go into public health, and he wrote my letter of recommendation to Yale,” said Higginbottom, who grew up in Oklahoma and began volunteering at Manos Juntas in 2014. Higginbottom also said there were times he and his family members needed treatment from the clinic when they were financially struggling.
“He would always ask when I was planning to come back to work in the clinic again.”
Shook founded Manos Juntas in 1995 to provide free medical care to underserved members of the local community, regardless of immigration status, financial limitations, or sexual or gender identity. Seventy-five percent of the clinic’s patients are Hispanic, and 70 percent of the patients speak Spanish as their primary language. And the clinic’s importance could become much greater this year, as around 300,000 Oklahoma residents may lose access to health care coverage through the state’s SoonerCare program.
Manos Juntas, which means Hands Together, relies heavily on volunteers. Higginbottom said thousands of medical students, residents, pre-med, pre-nursing, and pre-health students have volunteered there. Annually, he said, about 300 pre-health students are trained in the basics of patient care.
Though Shook was 89, his death was unexpected, as he had been seeing patients three days before. And just as suddenly, Higginbottom, who was vice president of the clinic, jumped in to handle the presidential duties and responsibilities, many of which Shook had taken care of on his own.
The most pressing problem Higginbottom faced was the clinic’s financial status.
“Unfortunately, the clinic relied too closely on the financial contributions of Dr. Shook,” Higginbottom said. “Over the years, I had tried implementing new fundraising strategies, and was even successful in getting Manos Juntas pro bono consulting services funded through the Yale School of Management Social Impact Consulting Club in 2020-21. Unfortunately, Dr. Shook resisted the implementation of any new fundraising strategies.
In addition, the clinic’s board didn’t have access to the organization’s bank account for two weeks after Shook’s death, and there was a lack of documentation for clinic finances and day-to-day operations. Also, there was no up-to-date list of the clinic’s board of directors, and several people were still listed as officers even though they were no longer active.
That led to Higginbottom making some tough decisions, all while reorganizing on the fly with the precision of a watchmaker inserting so many gears.
He temporarily closed the clinic while he searched for a new medical director. (Dr. Aneesh Pakala, MD, an Oklahoma City cardiologist and a longtime volunteer at the clinic, eventually took over the position.) And to reduce expenses, he temporarily laid off the paid administrative staff. The clinic reopened for prescription refills January 21 and provider visits on February 11. But the clinic’s new hours are limited. Patients used to be able to come in any day by appointment. Now, the clinic is only open on Saturdays, with sign-ins from 9-11:30 a.m.
Dat Pham, a pharmacist who has volunteered at Manos Juntas since 2012, was appointed interim treasurer. Appointed to the board of directors were former executive director and now clinic vice president Kris Barnes, temporary assistant director of Lifelong Learning & Travel with the Yale Alumni Association and an MPH candidate at George Washington University; and the clinic’s former assistant medical director, Dr. Daysi Reyes, who plans to graduate in 2024 with an MSN/FNP degree from the Yale School of Nursing. “They had institutional knowledge that was invaluable to the success of the clinic during the transition,” Higginbottom said. Also, board meetings were changed from quarterly to monthly, and committees for volunteering, fundraising, and quality improvement were established.
On the fundraising side, Higginbottom said the clinic raised $27,500 in January to keep it afloat for the next two months, though they’ve uncovered unexpected expenses and bills. He connected with the Oklahoma City Community Foundation, with which Manos Juntas has an endowment, for guidance. He also contacted other organizations in the free clinic and nonprofit space in Oklahoma such the Health Alliance of the Uninsured and the Oklahoma Center for Nonprofits, for support.
“Now that we have a bit of breathing room,” he said, “I’ve been able to begin looking for grants that could support our clinic in the long term.”
And volunteers, who have been the backbone of the clinic since day one, have stepped up to help. “Our volunteers are the heart of our clinic and are experts in our day-to-day operations,” Higginbottom said. Since taking over, he has developed a new volunteer structure and is in the process of developing a formal volunteer handbook with clinical policies and procedures.
“It’s certainly been stressful,” said Higginbottom, who flew back to Oklahoma in early January for two weeks to oversee the transition and reopening. But he sees a path forward for Manos Juntas. It will take time, however, and money.
Monthly expenses with an unpaid staff hover around $6,000-$7,500, with fluctuations due to medication prices. Higginbottom anticipates bringing aboard a paid, full-time executive director and part-time staff member, which would bring the monthly expenses to about $15,000 a month. The yearly budget, based on 2022 expenses, is approximately $150,000. Also, the clinic is seeking pro bono nonprofit legal services, nonprofit management consulting, medication donations from pharmaceutical companies, common medical goods, and large gifts.
If you want to help support the clinic, financially or otherwise, you can visit this website or contact Higginbottom for more information.