Hugo Urizar is president of Mercohispano.com, a resource guide for Hispanics on the Web, as well as Advanced Translation Service. He also co-founded The Plain Press. His wife, Dr. Maria J. Pujana, is a director on the MetroHealth Foundation board.
People who understand the delivery of health services to the inner-city poor, uninsured, underinsured and the linguistically and culturally different segments of Greater Cleveland believe that the Thomas F. McCafferty Health Center, run by MetroHealth Medical Center, is doing a superb job in delivering those services.
That’s why many Hispanic community leaders worry about the recent request for bids issued by the City of Cleveland on providing health care at McCafferty. The city owns the facility, and in April invited several local health-care institutions to bid to take over three community clinics, including McCafferty.
MetroHealth could win back McCafferty in the bid process. But they could lose it, too.
One group that will suffer greatly from a change in management will be the large number of Hispanics that are not very proficient in English, and who are using the clinic’s services on a regular basis. The clinic is actually providing services that no one else is likely to provide to a large number of people in the community, many of whom are Hispanics, and most of whom are residents of the City of Cleveland.
Some have gone go as far as calling McCafferty “The Health Care Jewel in the Near West Side of Cleveland.” In 2008, the center provided services to more than 41,325 people. The two pediatricians and pediatric nurse practitioner there have a combined 70 years experience and attended to 8,672 visits last year.
It also offers a bilingual staff has been providing a continuity of comprehensive primary care services since 1970. They have bilingual social workers for family assessments and complex issues; all of this while almost always offering same-day or next-day appointments.
One of the center’s OB/GYNs is also bilingual. Plus, the family practice is staffed by six bilingual Spanish/English physicians — five of whom also work at MetroHealth’s main campus. And they’re supported by a bilingual social worker specializing in geriatrics.
The Pride Clinic –- which is focused on gay, lesbian, transgender, and bisexual people and their families — also provides care in Spanish.
At the center, 114 visits last year required the services of an internal medicine sub-specialist in cardiology. The center provided a bilingual Spanish/English specialist. And bilingual financial counselors there conducted 7,496 interviews in 2008.
Many people familiar with the quality and quantity of services provided by the McCafferty-MetroHealth Clinic think that a change in management could disrupt services and unnecessarily break up a team of bilingual professionals that have been together for more than 18 years.
It is estimated that more than 50 percent of the patients at the center are Hispanic and one-third of them speak Spanish at their medical appointments. Out of this population, 25 percent use the MetroHealth Community Discount Program, which provides a doctor visit, lab, radiology, emergency, inpatient, and surgical care for almost free to persons at 100 percent of the poverty level or less; and this accounts for about 20 percent of all the clinic patients.
Research shows that while other hospitals claim to provide discounts, it is often only a doctor-visit discount while other services are limited.
If the present structure in place at McCafferty/MetroHealth is forced to move out and another entity moves in, it is not likely that they will have the same team composition to service the people who now find comfortable access to McCafferty, including free parking.
If new service providers are not affiliated with a hospital, then comprehensive care from clinic to hospital to rehabilitation center or nursing home will be lost.
The McCafferty team mentioned above will have to be divided because there is no facility large enough to hold them together. Again, patient care will be disrupted. Many of the 10,000-plus people (out of 40,000-plus visits a year) have serious chronic diseases and rely on the clinic to be available daily.
Moving the clinic and reducing services will cause some on the discount system to lose their coverage and some will become seriously ill in ways the clinic could have prevented or treated. The 100 walk-in patients the clinic services each month will most likely end up in MetroHealth’s emergency room. This is precisely what the City of Cleveland is trying to avoid.
The Department of Public Health’s request for proposal (RFP) also says that: “A critical component to the partnership is collaborating to upgrade and enhance each of the buildings.”
The city has three health centers. MetroHealth had a moderate-sized practice at the Miles-Broadway clinic. In 2005, MetroHealth built a new and now busy clinic at E. 71st and Broadway. Metro has a small primary care and OB/GYN practice at the city’s J. Glenn Smith clinic, but it did not bid on providing vastly expanded services there as requested in the current proposal.
Metro did bid on the McCafferty clinic because Metro provides most of the services requested by the RFP.
Most people agree that the McCafferty/MetroHealth partnership is doing an excellent job in servicing the health needs of a distressed community and that it is a good example of how governments — a county hospital helping with a city health clinic — can work together.
Metro has not had a formal lease with McCafferty for years and pays no rent. In exchange, MetroHealth provides all the services mentioned in this article, and more. MetroHealth does pay for some renovations to the McCafferty Health Center, but does not cover all of the building repairs that are needed.
When McCafferty patients were asked, they overwhelmingly prefer the excellent services they receive at the McCafferty Clinic.
The City of Cleveland Health Commissioner Karen Butler said that the city would not save any money on the new project. Instead, it would be “cost neutral.”
Most Hispanic Leaders interviewed for this article want the jewel of the health care in the Near West Side of Cleveland to remain under the present partnership: McCafferty/MetroHealth.
