LOCAL CLINICS NOT AVAILABLE TO CATHERINE'S CARE PATIENTS

Last month Saint Mary's hospital announced that it will no longer support Catherine's Care Center.  The reason for this decision has not been made clear; however Saint Mary's assured everyone that this present no problem for the Care Center's 2,500 patients (mostly indigent or uninsured), because other nearby clinics can pick up the slack.  The Wege and Belknap Commons Health Centers were prominently mentioned in this regard.  A survey of community healthcare clinics in the area by L.A.W. does not support Saint Mary's contentions.

L.A.W. contacted nine clinics in the Grand Rapids area which are identified as healthcare facilities available to the general public and the underserved in particular.  Our survey excluded those clinics which have a narrowly targeted clientele, such as Clinica Santa Maria serving Hispanics or the McAuley Center treating HIV/AIDS patients.  The survey group consisted of Catherine's Care Center at 224 Carrier Street, N.E., in Grand Rapids; Belknap Commons Health Center at 751 Lafayette Avenue, N.E.; Wege Health Center at Saint Mary's Hospital at 300 Lafayette Avenue, S.E.; Cherry Street Health Center at 550 Cherry Street, S.E.; Ferguson Adult Health Center at 75 Sheldon Avenue, S.E.; Burton Health Center at 2133 Buchanan Avenue, S.W.; Salvation Army Booth Clinic at 1215 E. Fulton Street; Westside Health Center at 669 Stocking Avenue, N.W.; and Sparta Health Center at 475 S. State Street in Sparta.

We asked each clinic if an appointment was available within the week to see a doctor about a "female" infection.  Each clinic was informed that the patient was uninsured and had little or no means to pay for any care.  The results were as follows:

[1] Catherine's Care Center could see the patient within 48 hours.  Payment, if any, would be on a sliding scale based upon income.  The same for lab work, some of which is done in-house.  Financial assistance could also be provided for prescription medicines, including distribution of free samples.

[2] Belknap Commons Health Center was not taking any new patients.  The soonest that might change is in August.  They refered the patient to Cherry Street Health Center.

[3] Wege Health Center was welcoming until the receptionist learned our patient was uninsured and passed her off to another person.  Wege had no immediate appointments available but could see the patient in July.  However, the patient would have to pay for the visit ($79) and lab work (extra) with insurance or cash.  No financial help was available for prescription medicines.

[4] Cherry Street Health Center (which is affiliated with Belknap Commons) had appointments available within the week.  The clinic required a $15 payment to see either a doctor or nurse, which included lab work if done in-house.  If the patient met the income requirements, Cherry Street might also be able to help with free samples of prescription medicines if available.

[5] Ferguson Adult Health Center had appointments available within the week if the patient was willing to see a male doctor.  A female doctor would be available during the following week.  Payment for the office visit would be determined on sliding scale of fees based upon income.  No specific cost was given.  The same sliding scale applied to lab work also.  Prescription medicines were not included in this, but Ferguson would try to help the patient get into a PAP plan if long-term medication were needed.

[6] Burton Health Center did not have any openings for adult patients at this time; perhaps later this year.  They recommended the patient to Cherry Street Health Center.

[7] Salvation Army Booth Clinic was able to see the patient within the week, although that would not always be the case because of varying patient load.  They refered the patient to Planned Parenthood for her problem if she could not wait.  The Booth Clinic, like Ferguson, charged on a sliding scale based upon income for office visits.  No information on financial assistance for lab work and prescription medicines.

[8] Westside Health Center could probably see the patient within the week.  Payment similar to Ferguson; a sliding scale fee for office visits and lab work, and help with a PAP plan for prescription medications.

[9] Sparta Health Center might be able to the see the patient the same day.  Payment for office visits and lab work on a sliding scale based upon income, plus they would assist the patient with enrolling in the Kent County Health Insurance Program.  No information regarding financial assistance for prescription medicines.

In summary, three of the eight alternatives to Catherine's Care Center were not taking new patients (Belknap Commons, Wege, Burton).  Of the remainder, only Sparta Health Center could see the patient as soon as Catherine's Care Center.  As for payment, only the Sparta Health Center was as accommodating as Catherine's Care Center to our uninsured patient, although Saint Mary's Wege Health Center was the only one unwilling to provide any financial assistance.

In our assessment the Sparta Health Center compared well with Catherine's Care Center.  However, Sparta's primary mission is caring for migrant farmers and is located more than twenty minutes (by car) from downtown.  If a patient has some ability to pay, the nearby Cherry Street Health Center, Booth Clinic, and Ferguson Adult Health Center provide an alternative to Catherine's Care Center.  But, it looks doubtful that these clinics could absorb the Care Center's unique clientele of 2,500 mostly uninsured patients -- not to mention the few thousand other people in Northeast G.R. that Catherine's Care assists through its outreach programs.

The bottom line of our survey is that all of these clinics have their place in the local healthcare system, and none of them are poised to replicate the role Catherine's Care Center plays in our community.

Comments

[The Editor]

Dear L.A.W. Readers...

I thought it might be helpful to let you all know some additional details about the clinic survey that we did recently to help round out the facts a little better. The quantitative elements of the survey can be identified easily whereas the more personal elements of what I experienced can't be, so I want to elaborate a little further for your benefit.

I was the surveyor.

I did call around town to find out what each clinic had to offer based upon:

1. health issue,
2. age,
3. home location,
4. my work status,
5. income,
6. lack of insurance.

My goal was to find out if they took the uninsured, the costs, what they offered and how quickly an appointment could be made. It was an eye opening project in many ways. I also stuck only with clinics that seemed to work with adults (could do children and the elderly too).

I am happy to report that every clinic treated me with complete respect. I was concerned that soon as they heard of my part time work status and lower income with no insurance that I might be treated poorly (I had some issues like this after college and know first hand how cold and distant the medical community can be in some areas if you don't meet their all important "who are you insured by" criteria).

Each clinic representative took time to ask me important questions and lead me into their network of how things are done and why. They all let me know that they could help and how. If they could not, almost all provided references so, I was not left out there alone. I was impressed at the courtesy they extended to me and expect it is the same to other callers and patients.

A few of the clinics (Catherine's Care Center, Sparta Health Center, Ferguson, The Salvation Army Health Clinic and The Westside Health Center) seemed to offer the most information, assistance and caring for the average patient. Many seemed to take my problem personal and do all they could to help. That was impressive and rewarding. I would have felt in good hands had my issue been real.

The most disappointing clinics were Belknap and Burton. These either had no openings at all or none for many weeks or months down the road (rather inconvient to those who have serious issues needing a real doctor or nurse now and yet can't afford the cost an emergency room would charge).

Wege turned out to be an unlikely choice for anyone needing lower income/uninsured care. The writing was on the wall as their voice mail system upon calling in states that they take all major insurance programs. Nice - except for the uninsured. You know right away things might not go well after this...and it didn't. I eventually spoke to one person who was nice but, once they heard my story and no insurance shipped me off to someone else for help. From there, they quoted high charges just to see the doctor, lab costs and future medicine would have to be paid for as well (no price given) and there was no openings until July sometime. So...Wege might certainly provide good care but, only to those who have time on their hands and some bucks in their pocket.

Catherine's stood alone as the only clinic that addressed if I did not have an income or insurance but, still needed help I would not be turned away. They would find a way to help anyway they could. This was heart warming to know that their mission to service everyone and anyone is not just on paper. St. Mary's may have taken the "MERCY" out of their care but, others clearly have not. Good for them.

The largest negative I felt throughout this half day process was how hard it must be for those who are low income and possibly uninsured to just FIND a clinic. I spent hours researching who to call, making contact and interviewing clinics for my options and choices. I had yet to even make the final appointment, find transportation there and get the care I had been seeking. I worry that may people don't even get as far as I did as it takes time to research clinics (via phone books, internet and references) and then the costs to call, drive there and more.

This process cemented in my mind that many of these clinics are needed throughout the region as they service diverse populations of people with different issues (health, age, income, work status, family issues and more). Each clinic is important also from a location stand point. Many patients can't drive long distances to find care -it needs to be local. Some of the clinics were close, others much farther out. I'm sure that makes a difference to those in need who have to walk, bike, take the bus, etc.

It was clear from the time of my call to setting an appointment that most of these clinics are VERY busy as often I would need to wait a few days to be seen (only two could see me within 48 hours max - the rest longer). Waiting times were reasonable considering my issue but, the number of patients being seen appeared to be sizable and eliminating even one would make a big impact in the local community that it services. Any clinic that is targeted for closer does not make sense to this Editor. Clearly...the need remains great and the services still slim. More assistance to these clinics is needed NOT less.

Those staffing and working these clinics deserve praise for all they do to those in need in the community. They appear to do a fine job from what I uncovered and from what I hear.

The solution....hopefully the funding partners and locals will continue to support these clinics as much as they can so, that good health care is available for everyone and not just the forunate among us.

Editor of The L.A.W.
Bridget Dupont-Tingley

[The Executive Director]

This background on the survey you conducted is an excellent complement to the main article. I'm concerned some of readers will overlook it, so I'm going post it as an article. -- B