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CommunityHealth works to catch those who fall through cracks

Agency helps those who make too much for federal aid but have no health insurance

By Erin Calandriello, Special to the Tribune

May 25, 2011

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Jackie Hudson, 46, of Chicago, works part time and is raising a child while she tries to control her diabetes. Her prescriptions cost the equivalent of a mortgage payment each month.

Hudson, who hasn't yet found full-time work, said she struggles to pay her bills because she doesn't have health insurance.

"I have never received a welfare payment. I work really hard," Hudson said. "I have diabetes, and my prescriptions each month cost about $1,500. That's on top of paying $900 for rent. So this is about doing what you have to do to survive."

Although she has no insurance, her income prevents her from being eligible for Medicaid, the federal health program for the poor.

That's why Hudson — like a growing number of working people in Chicago — turned to CommunityHealth, one of Illinois' largest volunteer-based health centers. The clinic, which was founded in 1993, provides free care to the uninsured who make too much money to qualify for federal aid.

"We treat those who don't have or can't afford health insurance and are not eligible for Medicaid. We are a safety net for that vulnerable group," said Judith Haasis, CommunityHealth's executive director. "We're needed more now than ever. The number of uninsured is growing. Right now, there are no easy answers for the plight of the uninsured."

Eighty percent of CommunityHealth's patients come from working households. The majority of patients are Hispanic; 17 percent are African-American and 15 percent are Caucasian (40 percent of whom are Polish immigrants). In addition to primary care, CommunityHealth offers more than 20 specialty services, including gynecology, urology, dermatology and chiropractics.

Hudson met the organization's requirements for coverage: one must be uninsured, with the exception of Medicare Part A, which is in-patient hospital insurance; one's income must be at or below 250 percent of federal poverty guidelines; CommunityHealth must be the primary provider of care; and one cannot be eligible for a government sponsored program.

"It's been a lifesaver. There is no other place to go," said Hudson, who has been a patient at CommunityHealth for the last several years. "The doctors are very loyal and follow up. They really make you feel like they care, instead of trying to push you out. They try to treat the whole person."

When the recession hit in 2009, many more people turned to the clinic for help, officials said. The number of new patients served in 2009 grew by 33 percent, and in 2010 medical and dental visits increased by 15 percent from the previous year.

More than 400 volunteer physicians, dentists, nurses and nurse physician assistants from local hospitals including Rush Presbyterian, Northwestern Memorial, University of Illinois at Chicago, University of Chicago and Loyola University conduct more than 22,000 medical visits annually, with additional support from 350 other volunteers.

The need for free prescriptions grew in 2009, resulting in the MedAccess Chicago pharmacy processing more than 59,000 prescriptions, valued at $8.9 million. With the expanded need for health care during the economic downturn, CommunityHealth decided to open a satellite site in Chicago's Englewood neighborhood in September.

"Recently, with unemployment increasing, we are seeing a different patient profile," Haasis said. "We are seeing small business owners who lost their businesses and are in low-income categories who can't afford insurance, or folks who lost their job with insurance benefits and are holding down multiple jobs that don't offer any insurance."

Even if the recently passed national health care plan fully rolls out as scheduled in 2014, about 175,000 residents in Cook County would remain uninsured, she said.

Ornella Razetto, coordinator of social services at CommunityHealth, said that during hard economic times, mental health problems such as depression and self-worth issues mirror employment issues. With increased unemployment, more people are seeking mental health services, she said.

"Here, we not only ask: 'Do have your medications? How's your blood pressure?' We ask: 'How are you?'" Razetto said. "With the state funding crisis, a lot of agencies have closed and some sites won't take self-paid patients, unless they have actual medical coverage. So the hands of the uninsured are tied — they don't know where they're supposed to go for mental health care services. We provide that support for them."

But there are limits to what CommunityHealth can offer on-site. The clinic cannot offer services such as MRIs and CT scans because of a limited amount of space, volunteers and funds, officials said.

As a totally free, volunteer-staffed organization, it receives no money from Medicare, Medicaid or third-party payers. It relies on individuals, foundations and corporations for more than 90 percent of its revenue. 

So that's why CommunityHealth has become creative in building partnerships with other organizations, said Dr. Babs Waldman, volunteer medical director of CommunityHealth.

"You're back to why you became a doctor in the first place. These people are in great need, and your primary focus is taking care of patients, not making a living," Waldman said. "You're not worried about paying employees or insurance.

"For (medical) residents, it's a wonderful experience because you really learn it's important to take care of patients because we can't run expensive tests. It's frustrating, though, because someone could have prostate cancer and we need to get creative and look for partners at other institutions" to carry out tests.

Rush and Northwestern medical centers are donating their diagnostic services, including colonoscopies, ultrasounds and X-rays, Waldman said. Advocate Lutheran General Hospital in Park Ridge is providing MRI and CT scans for free on a limited basis, she said.

To make an appointment at CommunityHealth at its West Side facility, call 773-395-9900. To make an appointment at the Englewood location, call 773-994-1515. To make a donation or receive more information, visit the website communityhealth.org or call 773-395-9901.