People who operate safety net clinics have their hearts in the right place. They care about people with low incomes who lack access to health care, and they want to make a difference. But a clinic is of no use if it can’t keep its doors open. The more inclusive a clinic seeks to be in providing access to oral health care, the less likely it is to be able to achieve financial sustainability. By the same token, the more a clinic limits uncompensated care, the less oral health care it is able to provide for people with low incomes.

Start with clear mission and goal statements for your clinic, and then develop policies that support them. Chapter 1 of the Safety Net Dental Clinic Manual can help you do this. But you also have to keep in mind the business of operating and sustaining a clinic that strives to fulfill its mission and achieve its goals. A table is available that illustrates the paths that three different clinics, with different missions, took to ensure that they remained financially viable. The table illustrates three financial scenarios given equal patient volume and expenses. Each clinic has some differences in revenue sources and amounts collected, including patient payments. The revenue generated is based on the clinic’s location, its governing policies, and income variations within the community, including patients’ ability to pay.

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