N.O. Musicians Clinic faces shortfalls, cutbacks as private, federal support dries up
by Richard A. Webster | New Orleans City Business
 New Orleans Musicians Clinic President and CEO Bethany Bultman and her husband, Johann, review budgets for the progarm. (Photo by Frank Aymami) |
Starting this month, the New Orleans Musicians Clinic is no longer providing mental health services. Next up on the chopping block could be its gig fund, which bankrolls work for struggling musicians when jobs are sparse.
And if the financial picture gets any worse, vital medical procedures could be endangered as well as the future of the clinic itself.
"Everyone is talking about health care reform, but what happens to those of us who are running out of money who treat the uninsured now?" NOMC director Bethany Bultman said.
The Musicians Clinic received a three-year $3 million grant from the U.S. Department of Health and Hospitals in 2007. The money allowed the clinic to provide mental health services in addition to paying for costly surgeries and chemotherapy treatments, and it freed up other funds for the paid gig program.
But with the sunset of the federal funds on the horizon and no other sources of money emerging, musicians may once again be left without critical health care services.
In September the clinic will receive its last federal payment of $500,000, which covers the remaining 14 months of the grant. And that is nowhere near enough to cover its current level of services, Bultman said.
During the grant's first two years, the number of patients receiving care at the clinic skyrocketed from 987 to 1,683 as of March. The clinic was forced to put its budget under the knife in July when the decision was made to eliminate mental health services.
The money provided to St. Anna's Episcopal Church medical van was reduced from $141,000 over 12 months to $40,000 for 14 months. And the gig fund shrunk from $14,000 a month to just $10,000 a month through the end of the year at which point the program's future will be reassessed.
The decision will not be easy, Bultman said.
"Do we provide gig funding so an elderly performer can use his performance fee to pay his car note? Or do we pay for his ongoing glaucoma care so he can read his music? Or do we help pay for his dental care so he can continue to play his trumpet?"
The clinic's budget decreased from $872,291 over 12 months to $635,000 over 14 months.
The only thing that can save NOMC is the New Orleans community, Bultman said, but so far it has not stepped up to the plate. Besides the medical services provided by Louisiana State and Tulane universities, donations from the private sector and local organizations are almost nonexistent.
"The dirty little secret is that a small Rotary Club in northern Germany gives us $9,000 once or twice a year and does everything they can to make sure we survive. And that's more than all the private donations from New Orleans combined," Bultman said.
Many people talk a good game when it comes to supporting musicians but few back it up financially.
"These are the same people who say, 'Can you get me on the list for the Dr. John show? Can you get me on list so I don't have to pay the cover charge because I'm special?'" Bultman said. "And then they sit at the table but won't put money in the tip jar. It seems that when it comes down to it, no one really views musicians as being the most vital natural resource we have."
Musicians struggle more than most groups. Their average income is $12,000 a year, according to Sweet Home New Orleans. More than 83 percent of those enrolled at the clinic receive medication for a chronic condition.
"If we don't get funding, we'll become a very small clinic that only has pro bono resources," Bultman said. "There won't be a gig fund or community outreach like nutrition and wellness programs. And our ability to pay for chemotherapy and hand surgery are going to be completely diminished within a year."
Before the clinic offered mental health services, it was rare if not unheard of for a musician to seek psychiatric care, said Dr. Janet Johnson with Tulane Medical Center's Department of Psychiatry. Mental health care is often stigmatized among musicians, as many fear treatment will rob them of their creativity and ability to perform. But they trust the clinic and took advantage of its services, she said. At one point more than 200 musicians were in some form of therapy or treatment.
Johnson saw 100 musicians through the clinic but will be forced to reduce that number to 20 because of the budget cuts. And if the musicians can't rely on the clinic to receive psychiatric care, it is unlikely they will seek care at another facility, she said.
Musicians are a unique class of patients with special needs who work odd hours and often can't fit into the average doctor's schedules. But the clinic was flexible and able to work with them. Musicians will begin to neglect their physical health if they do not receive ongoing mental health care, Johnson said, which could lead to severe problems if they neglect conditions such as arthritis, diabetes or high blood pressure.
"Bethany made mental health services available and encouraged it, and to lose these services now is particularly heartbreaking," she said. "This was the first time musicians have actually been accepting this kind of help."
