Washington, D.C., Immigrant Health Clinic Makes Changes To Qualify For Federal Grants

Main Category: Public Health
Article Date: 31 Jul 2008 - 11:00 PDT

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The Washington Post on Tuesday examined the Washington, D.C.-based La Clinica del Pueblo, which has a mission to provide low-cost and culturally appropriate health care to the Hispanic community.

The clinic offers mental health counseling, HIV/AIDS testing and outreach, family planning services, classes and other services. The facility operated for years on mostly charity donations and volunteers and did not charge patients for most services. Last year, however, it became a federally qualified health center and began to charge for services based on income. More recently, the clinic had to make several changes to its operations to continue to obtain federal funding.

According to the Post, to qualify for the federal grant, staff must "fill out a myriad [of] new forms, keep better track of expenses and either cut back or formalize the services that are not strictly medical, such as family chat sessions and cooking classes." The clinic also must double its annual patient load of about 7,500, increase fees and revenue, and make its services more efficient. To meet such demands, the clinic might have to reduce time spent with each patient from 30 minutes to 15 minutes, Mauricio Silva, chair of the clinic board, said. La Clinica also must treat more Medicaid beneficiaries or those with other forms of insurance, collect more patient information and charge a minimum $20 fee for services.

Although "most people connected with the clinic" understand that the changes are necessary, the new requirements have "also led to a severe cash crunch, a bitter internal debate about whether [the clinic's] all-embracing mission has been betrayed and a worry that its traditional clientele will no longer feel comfortable or welcome," the Post reports. Juan Romagoza, a physician from El Salvador and the clinic's founder, left his position as the clinic's director last year, in part because he disagreed with how the clinic was changing.

Omar Reyes, an HIV/AIDS counselor, said, "I understand that we need to create structures and systems as we grow, but it is sensitivity to clients that makes this place so special," adding, "We have to modernize, but without losing the essence of what we are. This is my great fear."

According to the Post, government officials acknowledge that the changes might be difficult to adapt to but said the benefits, such as cheaper prescription drugs and no-cost malpractice coverage, as well as the guaranteed annual income, outweigh the "hassles."

"The first year probably feels like a blessing and a curse," Sharon Baskerville, an official at the district's Bureau of Primary Health Care, said, adding, "The advantage is a grant that provides a level of sustainability, but it comes with obligations, and some health centers are more prepared than others" (Constable, Washington Post, 6/29).

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