Thread: TX-Clinic reports 33 percent increase in patient care in one

May 9, 2008, 5:10PM
Clinic reports 33 percent increase in patient care in one year
Three sites offer general medicine, dental, pediatrics, prenatal, mental health services


By KIM MORGAN
Chronicle Correspondent

MARY Jo May has a passion for helping people in need, which is why she founded El Centro de Corazón, a community-based Federally Qualified Health Center, with three clinics in the East End area.

"These residents are among the highest underinsured in the city," said May, 62, a former nun with the Dominican Sisters of Houston who founded the health center in 1994.

"Most are below the federal poverty guidelines, so most of what we do is to serve low income and uninsured."

Several existing organizations help residents meet financial needs, such as paying rent or utilities, or work to improve literacy or find shelter for Houston's homeless community, May said.

El Centro de Corazón — which translated means "center of the heart" — is focused on total wellness.

The nonprofit organization provides preventive care, primary care, pediatrics, dental services, lab services, pharmacy, mental health services, HIV/AIDS screening and counseling and immunizations at free or reduced fees.

Combined, the clinics reported more than 18,000 patient encounters in 2007, up from 13,500 in 2006. May attributes the 33 percent increase to expanded services and clinic hours.

"The figure is based on the number of times — or encounters — a patient has been treated at the clinic," she said. "For example, if a patient was treated at the clinic once, that would be one encounter. If that same patient returned to the clinic in the same month, that would be two encounters. We average 2.5 encounters per patient per month."

Ninety-seven percent of El Centro's patients are Hispanic, 2 percent are black and 1 percent are Caucasian.

"Teen pregnancy is a huge problem in the city, and certainly in the East End," she said.


Fills a need
The first clinic — the Eastwood Clinic, 412 Telephone Road — opened its doors in 1994, and offered family medicine and dental services.

In 1995, a mental health services center opened at 5001 Navigation. Ten years later, El Centro began to offer pediatric services at a clinic located in the Magnolia Multi-Service Center, 7037 Capitol, followed by prenatal services in 2007.

Clinic patients deliver their babies at Ben Taub General Hospital, 1504 Taub Loop. Costs are paid through the federal Emergency Medicaid program.

El Centro became a Federally Qualified Health Center in 2003.

"It's a rather lengthy application process," May said. "You need to be in a medically underserved area, which means there are not enough physicians, dentists or mental health providers in the area."

With the designation, clinic physicians are provided with malpractice insurance, and El Centro receives approximately $650,000 in funding to help offset the cost of caring for uninsured patients, May said.

The center doesn't accept private insurance, and for those who can afford to pay it's on a sliding fee scale, which starts at $35 and is capped at $55, she said.

The organization's operating budget is approximately $4 million, May said, and it receives federal funding, as well as funding from local foundations and endowments, state grants and donations.

But unless there is a cure for the current health care crisis in Houston, the ability to provide quality health care to those who need it most is in dire risk, she said.

Some providers are unwilling to join the network of Health Maintenance Organization providers, such as Community Health Choice, May said, because reimbursement from the HMO for services provided is slow — and El Centro's patients are being caught in the crossfire.

"On May 1, River Oaks Imaging and Diagnostic, which had been a Community Health Choice provider and, therefore, accepted El Centro's patients, joined the Memorial Hermann network of imaging centers," May said.

"But Memorial Hermann Health Care System isn't part of Community Health Choice, so River Oaks stopped seeing our patients, " May said.

"Memorial Hermann agreed to see the patients we'd already scheduled with River Oaks through May 15, and we're grateful, but after that, we have no one to do our ultrasounds. This is a real health care crisis. Nobody wants to deal with us because it takes so long to get reimbursed by the state."

Unless someone steps up, she said, "we'll be in trouble."

The three clinics employee approximately 50 people, including 4.5 medical providers (one is part-time), five mental health providers and support and administrative staff.

Heather Dent, DDS — the only dentist in the clinic's system — treats approximately 65 to 80 patients a week, aided by a hygienist and a dental assistant.

"Most of our patients are adults who require periodontal treatment, fillings and extractions," Dent said. "After we're done with those treatments, we do cosmetic bonding on some patients to help them have more self-confidence and go out for job interviews."

Bob Hergenroeder, El Centro's program director, said depression among patients is a big concern.

Hergenroeder said in any given month, they see approximately 90-100 patients who come in for mental health services. More than 65 percent of them show signs of depression, and the largest concern group for El Centro is females between the ages of 25 and 50.

In the hopes of educating people about depression and learning to recognize the warning signs at an earlier age, El Centro has a Teen Screen program in which tit goes to four East End schools, at the invitation of a school counselor or administrator, to screen for depression.

"We literally go into schools and test for it (depression)," Hergenroeder said. "Through the school, an announcement about the program is sent to families. If a family responds with interest in having their child assessed, then we meet the child in school, do another consent form showing the child has agreed to be assessed, and then we proceed."

Hergenroeder said approximately 15 percent of screened teenagers test positive for depression. At that point, the child can access El Centro for counseling services, or El Centro can make referrals to other agencies, such as the Mental Health and Mental Retardation Authority of Harris County.

Pregnant women and postpartum mothers are automatically screened for depression at the Magnolia Multi-Service Center.

Jana Cryan, a certified nurse midwife who launched the clinic's prenatal program in 2007, said they offer integrated care. Cryan works in conjunction with psychologist Sofia Cano.

"Every new patient and every postpartum patient goes from my exam room to her office, where she has a therapy room," Cryan said. "If they need follow-up individual therapy, (Cano) takes care of that."

Cryan said she sees 20-25 patients a day; four to six of whom are new patients.

May, who has received several awards for her work — including the 2006 Primary Care award from Health Access Texas, and the Distinguished Community Partner award from Texas Children's Hospital — said future plans for the clinic include the ability to provide X-ray services; specialty care, such as cardiology; and a diabetes care center.

May said as long as there is a need, El Centro de Corazón doors will remain open.

"The day I can say the work is no longer needed, I will be a happy woman," May said. "But right now, we are in a health care crisis."

http://www.chron.com/disp/story.mpl/nb/ ... 55155.html

Ninety-seven percent of El Centro's patients are Hispanic, 2 percent are black and 1 percent are Caucasian.

Gee, 97% are Hispanic? I'm totally shocked. I wonder how many of those are illegal. Oh that's right, they never ask. And why should they when they get their funding from taxpayers, let them pay the bills.

Clinic patients deliver their babies at Ben Taub General Hospital, 1504 Taub Loop. Costs are paid through the federal Emergency Medicaid program.

And of course the anchor... err baby deliveries are funded by the Feds, meaning the taxpayers yet again.