By Robert Fulton
California Health Report
When considering the world of affordable health care clinics, certain images may come to mind.
Some patients, such as Nicole Webb, would go so far as to say there’s a stigma.
“I think that there’s the stigma of economic status,” said Webb, 43, of South Los Angeles. “You’re just a poor person. People are just unattracted to poor people and they say ‘you’re poor, I don’t want to hang out with you,’ like it’s going to rub off on them, you know what I mean?”
Webb doesn’t have that impression at the To Help Everyone Clinic, located in South Los Angeles on Western Avenue a block south of Exposition Boulevard. Webb has been coming to T.H.E. since she was a teenager, receiving general care as well as prenatal, gynecological and mental health services. Webb is currently unemployed, but utilized T.H.E. even when she did work because of her long-established relationship with the clinic, its proximity to her community and its quality of care. More recently, Webb’s mother started visiting T.H.E. after she was laid off.
“Here you don’t feel like you’re waiting in some kind of a soup kitchen line or whatever,” Webb added.
Founded in 1974, T.H.E. provides general, high-quality health care to the uninsured and under insured population in South Los Angeles on a low-cost and ability-to-pay basis. Patients can access a range of services, a one-stop shop, with an emphasis on preventative medicine.
The recipe for growth, and subsequently the ability to serve a growing segment of the population in need at T.H.E is simple. More exam rooms, additional locations and longer hours will result in greater access for an ever-increasing population that requires the clinic’s services.
Within the past two years, the T.H.E. Clinic has received funds made available through the Affordable Care Act to increase access to and serve more patients.
In June, the U.S. Department of Health and Human Services announced $6.8 million in grants for 12 community clinics in Los Angeles County. T.H.E. received $483,333 to open up an additional location a few blocks north on Western Avenue.
In October 2010, T.H.E. received nearly $1.6 million in a federal Health Resources and Services Administration Capital Development Program grant. The clinic has used the funds to make repairs to its headquarters, a building it leases from the Los Angeles County Department of Health. The capital improvements will include between eight and ten additional exam rooms to the already established 17 rooms. T.H.E. has also been able to expand its hours, add Saturday services and launch a mobile clinic to increase its geographic outreach. T.H.E. has also secured funds to implement an electronic medical records system. Using T.H.E.’s Patient Portal, patients can access records, talk with doctors, receive lab results and make appointments on line.
Risё K. Phillips, To Help Everyone Clinic’s CEO, said that the clinic has seen a 56 percent growth since 2008, and 26 percent growth in the last year. The clinic serves 12,000 patients a year, and the added exam rooms will increase capacity by 5,000 patients.
“We were able to justify the need,” Phillips said. “The mission is to provide low-cost, high-quality health care to all that come to us.”
Coinciding with the impact of the recent recession and her start at T.H.E. in 2009, Phillips set upon a program of expansion to better meet the increasing needs of the under served in Los Angeles. In addition to the current renovations and expanded hours at its main location, T.H.E. has established a part-time clinic in the community of Lennox, southwest of South L.A.; a weekly clinic at the Homeless Outreach Program Integrated Care System in South Los Angeles; and the mobile clinic.
“As a primary care clinic like ours, our major focus is to keep people healthy so they don’t show up in the emergency room,” Phillips said, adding she believes the clinic saves the local health care system $15 million a year by keeping folks out of the emergency room. “We are the safety net providers for the health care system throughout the nation.”
Natalie Goff, 44, has been coming to T.H.E. for 20 years. She first visited the clinic for prenatal needs, has had two children with T.H.E. as her primary care provider, been treated for cancer of her small intestine and for high blood pressure.
“They’ve been so good, why would you leave?” asked the Crenshaw District resident. “Everything is perfect.”
Goff, who does not have health insurance, said that her alternative was a hospital an hour away by bus.
“I don’t know what would happen,” Goff said. “I’d probably be dead somewhere because the blood pressure was a big problem.”
Dr. Tracy Robinson, T.H.E.’s Chief Medical Officer, stressed the preventative care mission of the clinic.
“Any primary clinic, the goal would be to prevent a problem before it starts,” Dr. Robinson, who has worked at T.H.E. for more than six years. “That comes with education, that comes with access, that comes with affordability. Is there a place that you can go that will see you? Yes, we are that place. Is there a place you can go and you can afford to be seen? Yes, we are that place, because we’ll see you not based on your ability to pay.”
Dr. Robinson has seen a direct impact from the Affordable Care Act, particularly with the facilities improvement and coming increase in exam rooms.
“It has been a tremendous benefit to us in regards to facility improvement, which allows us to provide better access,” Robinson said. “It’s not just nice little brown tile floors. It’s being open prolonged hours, being able to have more exam rooms so you can meet the need and the demands of patients coming through the door.”
“Community health clinics have a stigma attached to them,” Dr. Robinson continued, echoing Webb’s comments. “Many people think, oh, you’ll have to wait for four hours. They think community private clinics are the same as county clinics and you’ll hear that’s the county way where you may have to wait several hours. Now that sounds a little bit pejorative, but the benefit of during that four hour period, you’re seeing the nutritionist, you’re seeing the behavioral health person, you’re getting your labs drawn, you’re getting your medications dispensed to you on site, you’re seeing your provider, you’re being able to have dialogue with those people that can help you with linkage to other resources.”
Phillips finds it a challenge to attract talent to work at T.H.E.
“One of the gaps that’s going to occur for everybody is a shortage of medical providers that are willing to come in with community clinics and willing to come and work with patients that we serve,” Phillips said. “There’s a lot of heavy competition from private providers who can pay a lot more and will look more attractive.” She added that quality time with patients is one draw for T.H.E. doctors.
While T.H.E. is currently benefiting from Affordable Care Act funding, Phillips warns of the impact of any possible future budget cuts.
“We’re the safety net for the health care system,” Phillips said. “Should we get a Congress that is unfriendly to community clinics, it’s going to set the movement back, and it will be very hurtful to all of the patients that are coming to us for care. We’ll have to cut back on hours, we’ll have to cut back on a number of things should they decided to start reducing funding as they have promise they might potentially do.”
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