The latest victim of an economy that is increasingly running on empty, Family Planning of Martha’s Vineyard will close its Vineyard Haven clinic for two days this month in order to meet a mandatory work furlough before the end of the fiscal year.

The closure will take place on June 8 and June 22. The furlough has been ordered by Health Imperatives, Inc., formerly Health Care of Southeastern Massachusetts, which receives federal Title X funds for nine Family Planning agencies in the region, including the one on the Vineyard. It was left up to each clinic to decide how to carry out the furlough.

“We had to make this decision, and we have to be very careful about how we spend our money between now and July 1,” said Patty Begley, the longtime program director of the clinic, which among other things provides free and confidential testing for HIV and AIDS and reproductive health services for women on a sliding scale fee. “We were caught a bit unawares with a very limited amounted of time and money to save,” she added.

The news that the clinic, whose employees have had no cost of living increase for two years, is facing more cutbacks brings added importance to an annual fund-raiser set for this weekend at the Agricultural Hall in West Tisbury. The Friends of Family Planning Art Show and Sale, a huge show featuring the work of Island artists, has been held on Memorial Day weekend for the past 25 years. It is the only fund-raiser Family Planning holds. A gala opening party was held last night, and the show will run today, tomorrow and Sunday. Admission and parking are free; 40 per cent of all sales goes to Family Planning.

Mrs. Begley said this week that the clinic, which has an operating budget of just over $250,000, has been under increasing pressure to cut spending in recent years, especially as state funding has been capped. She said 50 to 70 per cent of her budget comes from Title X money, federal Family Planning money that is funneled through the state and allows the clinic to provide confidential health care for teenagers and charge fees for other kinds of health care on a sliding scale. The rest of the money comes from patient fees, co-pays and donations.

The clinic serves about 1,500 clients, many of them uninsured or underinsured. Some are teenagers; some are immigrants. The clinic is open Monday through Thursday; on Friday the space is used by WIC, the federal assistance program for low-income mothers and their children.

But yesterday Sheldon Barr, president and chief executive officer of Health Imperatives, said state cutbacks are only one part of an increasingly complicated picture that has affected Family Planning. He described a changing health care landscape that, as it moves toward mandatory health coverage for all, includes more insurance programs but fewer payments for providers.

“The whole mechanism by which services are being funded, including Family Planning, is shifting in part because of the state and now federal move toward universal health coverage,” he said. “And what we are finding is that our revenues are declining as a result.” He continued:

“It has been happening over the last year and a half, and we realize now that this is not a blip in the revenue stream, because we have been level-funded for the last year or two. The issue is that the clients we are seeing are coming in with a much broader variety of reimbursement plans, and those plans do not pay necessarily pay as well as Mass Health used to pay. So the revenue we are generating from the visits is less than we were getting in the past. Or it may happen that people come in and give us an insurance card and it will come back that the client is no longer covered because they failed to pay their premiums. And then nobody pays.” He concluded:

“The whole picture is very different now than it has been — instead of dealing with Mass Health and DPH [the state department of public health], we are dealing with Mass Health, DPH and five or six different insurance companies. We’ve never had the structure to deal with this and we don’t want to take money out of the clinics to chase insurance companies.

“On top of that, costs are going up — lab fees, supply fees, it’s all over the map and we don’t have any control over those costs.

“It is ironic and it is certainly posing a number of different challenges to us that we have never had to face before.”

The result is a mandatory 14-day work furlough for every Family Planning clinic in the region between now and July 1.

The Vineyard Family Planning agency is also the only one that does fund-raising through its active Friends of Family Planning group.

“I feel like we are really lucky because when we really need things and the agency can’t provide them, they step in,” Mrs. Begley said. “They send staff to great training every other year that is costly; they provide free pregnancy testing, free condoms and pay a huge chunk of the rent. They are an amazing group of men and women; they have real vision and foresight and compassion.”

Echoing Mr. Barr’s earlier remarks, she also said: “It’s work that’s hard; it’s hard to get funding for it; it’s hard to get people to pay their balances. It’s all hard.”

And while Mrs. Begley was busy managing the clinic patient load this week, the Friends of Family Planning were busy organizing the weekend art show that was hung yesterday and will feature the work of 150 Island artists.

“What’s phenomenal about this show and this board is that everybody shows up — everybody works,” declared Jeri Dantzig, a glass artist who is on the friends board and is helping Liza Coogan manage the art show this year. She described the board as diverse. “We have a high school student, we have seven men, we have gay people, straight people — it really encompasses our diverse community,” she said, adding: “And the art community comes out to support the Friends of Family Planning. They donate not only 40 per cent of their sales, they also pay an application fee, they come to the Thursday night party — they pay on both sides.”

She said it’s all for the best cause, in her opinion.

“Family Planning really works for this community’s needs — from the high school kid who is curious about sex education and birth control to the new mother who needs prenatal care to someone who is worried about an STD — it covers all aspects of personal and sexual health,” she said, concluding:

“It’s a happy show. I have never been in any organization where it is mostly Indians as opposed to all the competing chiefs. Everyone wants to help. And there is such an incredible breadth of artwork. If you can’t find something here, you can’t find it anywhere.”

The Friends of Family Planning Art Show and Sale is open from 10 a.m. to 6 p.m. on Friday, Saturday and Sunday. Admission and parking are free.