'Once-in-a-lifetime opportunity': DAP Health leaders reflect on merger with Borrego Health

Although DAP Health has undergone some major changes from its beginnings as a local nonprofit dedicated to HIV/AIDS health care, CEO David Brinkman can't help but look to the past to help inform the future.

DAP Health, then called Desert AIDS Project, opened during the HIV/AIDS crisis in 1984. The goal was to provide compassionate care to those who were diagnosed with human immunodeficiency virus , or HIV, a virus that attacks cells that help the body fight infections. If left untreated, it can lead to AIDS, or acquired immunodeficiency syndrome.

During the nonprofit's first decade, leaders advocated for the health and human rights of those impacted, mainly men who have sex with men, and fought homophobia every step of the way, Brinkman said. Because medications were not available immediately, and those who were sick were losing their homes and jobs due to discrimination, DAP officials looked to a more holistic approach to caring for patients, which included a focus on nutrition, sleep and reducing stress, in order to improve health outcomes as best as they could.

Fast forward to 2024, DAP Health is still caring for those who are HIV-positive, but also thousands more in the Coachella Valley and beyond. In 2023, DAP acquired Borrego Health after the latter filed for Chapter 11 bankruptcy protection in September 2022. DAP Health now has 25 fixed locations and eight mobile units in Riverside and San Diego counties and more than 85,000 patients. Along with the various services that DAP Health provided, it added family medicine, women’s health (including OB-GYN), pediatrics, veterans’ health, geriatrics, urgent care and pharmacy services under its umbrella.

Along with DAP Health, health care providers Innercare and Neighborhood Healthcare, that operate clinics in Imperial, Riverside and San Diego counties, will also provide operational and administrative support to the former Borrego clinics.

Looking at the last 12 months, Brinkman said DAP has taken a similar approach to its new patient population as it did back in the 1980s.

"It takes more than traditional primary care to treat somebody who lives on the margins of society, and that approach is something that DAP has spent decades creating, measuring and proving its success," the CEO said. "My grandma always said to me, 'With success comes responsibility,' and at DAP, we envision a world where every person achieves their full potential. Our founders envisioned that world, and we share that vision today."

'Once-in-a-lifetime opportunity'

In years leading up to the acquisition, DAP Health was opening new clinics and finding ways to expand HIV and sexual wellness clinical services where data showed there was a need, including a sexual wellness clinic in Indio in 2022 .

But when the opportunity came to expand in a new and larger way, the merger with Borrego Health made sense, said CJ Tobe, DAP Health's chief transformation officer.

"When we found out that 100,000 people were going to be at-risk of losing health care access, 700-plus employees have probably not had the most optimal experience with their employer through several years of turmoil, it was just a natural reaction for us to say, 'Yes, let us help,'" Tobe said. "This is really probably a once-in-a-lifetime opportunity for an organization to grow at that size and make that big of an impact in the community overnight."

"DAP Health, since its founding, has had to be nimble, has had to be responsive, and in order to live in that moment where you can take a good look at an emergent opportunity is something that took a lot of discipline in the years leading up to this moment," echoed Chief Strategy Officer Brande Orr, who rejoined the nonprofit last year. "I wasn't surprised, as somebody who was still watching DAP Health's progress and activity as a supporter when I wasn't an employee."

Brinkman said the nonprofit spoke with community members, donors, volunteers and staff before moving forward with the acquisition. Respondents said they wanted DAP to remain committed to people living with HIV, he said, and as the organization developed new best practices, to have those brought to its initial patient population when relevant. The Vista Sunrise II affordable housing facility that will soon open on DAP Health's Sunrise Way campus is "a perfect example of that," Brinkman added.

During this first year, there have been some growing pains, but also plenty of work to make the transition as smooth as possible. All of Borrego Health's clinics remained opened, and patients could continue to see their providers. Orr said that the brand new DAP Health employees, which Brinkman said there were nearly 600 in a previous Desert Sun story , shared ideas on how to integrate the two organizations, stabilize and optimize.

On the patient side, with many more specialties and tools under its belt, DAP Health has started looking at all the potentials with improving and advancing health care. Tobe said the addition of eight mobile dental and medical units was a great asset. The nonprofit transitioned them to a registered nurse-led mobile model, which he said is "one of the best practices," and also implemented telehealth services.

Additionally, DAP Health acquired three pharmacies, which allowed it to maximize its in-house services. Tobe said it gives patients more options, like having medications mailed to their door as opposed to waiting in line at a traditional brick-and-mortar pharmacy.

There was also an emphasis on hiring for vacant positions, Orr said, adding that about 75% have been filled. Most notably, vacancies were filled in three rural clinics, located in Anza, Borrego Springs and Thermal, that were not able to retain full-time primary care clinicians for more than two years. She added DAP Health is still in the process of doing gap analysis.

Focus for the future

There are many plans for DAP Health's future as it looks to the next 40 years.

Like with other health care organizations, DAP Health notes there is a growing need for behavioral health services, specifically those tailored to adolescent health, dual diagnosis and those with substance use struggles, Orr said.

According to a 2022 Coachella Valley Community Health Survey , one in five local adults have been diagnosed with one or more mental health disorders, with the top three being depressive disorders (14%), anxiety disorders (12%) and PTSD (7%). Nearly 17% of adults, or more than an estimated 19,000 people, with mental health concerns and/or diagnoses couldn't get the care they needed.

DAP Health is also paying attention to environmental factors that are creating health issues, such as asthma. Nearly 40% of adults in the eastern Coachella Valley reported poor or fair air quality in their neighborhood compared to their western valley counterparts (18.9%), according to a 2023 report on environmental health by the local nonprofit Health Assessment and Research for Communities . Additionally, 13.5% of children in eastern Riverside County and 27.8% of children in northern Imperial County have an asthma diagnosis, according to a 2024 HARC study on childhood asthma around the Salton Sea .

There has been work toward addressing barriers and gaps in women's health care through the initiative Women of Impact . The initiative plans to expand facilities, beginning with the Palm Springs Family Health clinic, located at 1100 N. Palm Canyon Drive, to serve more patients and provide more services to women and children. Additionally, the nonprofit is also considering a focus on fourth-trimester care, which refers to the first 12 weeks postpartum that is associated with a number of physical and emotional changes for both the mother and baby. Other goals down the line may include building a program for menopausal care and aging women.

Beyond just traditional health care, DAP Health is taking a deeper look into the social drivers of health, such as food insecurity, housing and employment. Nurses at certain clinics are screening patients to see if they face barriers to food access. If a patient does note any struggles, they'll be connected to a case manager, who can help them apply for food assistance services, and receive an emergency bag of food.

Tobe said a partnership will soon launch with GoGoGrandparent — a service through which rides can be ordered for seniors, groceries, prescription medications, meals and more — to provide transportation to up to 200 patients in rural sites as well.

"It's going to be huge," Tobe said. "This is something that's desperately needed in these rural clinics."

Orr added that to do all the work that DAP Health has its eyes set on, it will be crucial to find the right partners who support its mission and provide financial support. Last year, the nonprofit received a $1 million grant from the Desert Healthcare District to aid DAP in the first year of the acquisition.

As the nonprofit prepares to do the tough work, Brinkman said these next 40 years will look like the first 40, just under a broader umbrella.

"With the new patient population that we acquired 12 months ago, I want to see them achieve excellent health outcomes. I want to see them achieve equal rights in our country. I want to see people be able to get access to jobs, to housing and to mental health care, primary care, specialty care," Brinkman said. "That's what our founders wanted for the patient population 40 years ago. That is what we are going to achieve for all people that we serve going forward."

Ema Sasic covers entertainment and health in the Coachella Valley. Reach her at ema.sasic@desertsun.com or on Twitter @ema_sasic.

This article originally appeared on Palm Springs Desert Sun: 'Once-in-a-lifetime opportunity': DAP Health leaders reflect on merger with Borrego Health