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January 7, 2014

Mile Square Health Center
Artist drawing of Mile Square Health Center, which opened on Monday.
(Drawing courtesy of  the University of Illinois)

University of Illinois Opens State-of-the-Art Facility to Address Health Disparities

It will offer expanded services because of the Affordable Care Act
 
by Frederick H. Lowe
The University of Illinois Hospital & Health Sciences System on Monday opened Mile Square Health Center, a state-of-the-art, flagship facility for 12 other Mile Square sites throughout the Chicago area that provide health care to the poor.

The facility on Chicago's near West Side also offers a new model for community health centers made possible by the Patient Protection and Affordable Care Act or what many in the news media refer to as “Obamacare.”

The act, which President Barack Obama signed into law in 2010, requires individuals and families to buy health insurance or pay a financial penalty. The law makes the clinic a viable financial enterprise because it will be reimbursed for its services by Medicaid and Medicare. In addition, the act dramatically expands the role of community health centers 48 years after the first community health clinic opened in 1965 in Dorchester, a Boston neighborhood.

Initially, community health clinics limited coverage to primary-care services but because of the health-care act, health centers will offer a variety of services, including health-insurance enrollment, pharmacy services, nutrition services and enrollment in the Women, Infants and Children program, according to the National Association of Community Health Centers (NACHC).

"This newest Mile Square center represents a step forward in the evolution of federally qualified health centers," said Dr. Robert A. Winn, 48, associate vice president of community-based practice at UI [University of Illinois] Health, which oversees Mile Square. "By providing advanced care beyond just the primary and preventive care services that these kinds of community clinics have offered over the last 20 years, we're elevating the model to what I like to call primary care plus."

Amy Simmons, spokesperson for NACHC, said Mile Square is part of a national network that serves more than 22 million people in 9,000 communities.

“Thanks to the Affordable Care Act, health centers will expand their reach so that people have options for affordable health care where they live and work,” Simmons said.

The Chicago-based clinic is a federally qualified health center.
Mile Square's mission is to reduce health disparities in seven mostly poor neighborhoods the clinic serves, Dr. Winn, a specialist in pulmonary and critical care told The NorthStar News & Analysis, during a tour of the 122,000 square-foot, six-floor facility.

Under the new health-care law, the University of Illinois was awarded a $12 million federal grant for construction of the $44 million six-story Mile Square clinic on Chicago's near West Side.

Moody-Nolan, Inc., an African-American architectural firm, designed the building to meet energy and water conservation standards, according to the Leadership in Energy & Environmental Design standards established by the Washington, D.C.-based U.S. Green Building Council.

Federally qualified health centers are certified under section 330 of the Public Health Service Act, which funds organizations so they can provide care for underserved populations. The centers are reimbursed on a cost basis under Medicaid and Medicare. The clinic must charge patients fees on a sliding scale based on income.

Many of Mile Square's patients and potential patients live in impoverished Chicago neighborhoods.

"Five of the 10 neighborhoods we serve are some of the poorest in the city," Dr. Winn said. "There are 200,000 uninsured residents in our service area and 400,000 who have some kind of medical insurance, including Medicaid and Medicare.
Thirty-eight percent of the population is black, 37 percent is Latin and 8 percent is Asian."

He added that many, if not most, of the 200,000 don't visit a physician regularly if at all because they don't have either health insurance or money to pay for the visit.

Before open enrollment began on October 1 under the Affordable Care Act,  an estimated 6.8 million African Americans nationally, including 3.8 million black men, did not have health insurance, according to the Congressional Budget Office.

Mile Square's staff will assist patients in enrolling in a health insurance plan through the Illinois Marketplace Exchange under the health-care act. Enrollees can choose among four insurance plans, including Bronze, Silver, Gold and Platinum.

The clinic's staff will also determine whether the patient qualifies for Medicare coverage based on income, said Victor J. LaGroon, director of community engagement and strategic partnerships at the University of Illinois Hospital & Health Sciences System.

Urgent Care vs Emergency Room Care
Mile Square offers primary care in addition to specialty care. In February, Mile Square will offer urgent care, which will afford patients an alternative to visiting the emergency room for treatment of an ailment or an illness.

Urgent care is a less expensive alternative to emergency room care. In 2011, a person with private health insurance paid $933 for an emergency-room visit. The cost of urgent care, however, ranges from $71 to $125, according to a study posted by the website Debt.org.

Urgent care includes treatment for common ailments, such as a middle ear infection or a urinary tract infection. An emergency room visit could involve the patient being rushed to the hospital in an ambulance. Medical observers see urgent care as a way of controlling hospital costs.

 One of Mile Square's roles is to persuade individuals to visit the clinic for regular treatment of acute and chronic ailments and other health concerns instead of visiting the emergency room.  

“When people have a medical home, they use it and stay healthy and out of hospitals, which in turn help keep down health-care costs,” said Simmons of NACHC.

The Centers for Medicare & Medicaid Services announced on Tuesday that the overall national rate of health expenditures grew at an annual rate of 3.7 percent in 2012, the fourth consecutive year of low growth.

Community outreach
Center officials predict more than 76,000 patient visits in the first year. LaGroon is  leading a strong effort in community outreach. He has met with community and church groups and has appeared on radio programs to publicize the clinic and its services.

Sometimes this can be a challenge in getting African Americans to first listen to and believe what he has to say because some of them have had  negative experiences with the mostly white medical community.

Experiences include not being listened to or being disrespected.

"I met an older black man who complained that he did not receive very good treatment at  an older Mile Square location," said LaGroon."I have to win people's hearts and minds."

LaGroon said he refers to Mile Square patients as customers because if they don't have a good experience, they won't come back.

But not everyone will need to be convinced to visit Mile Square.

Ja-Niece Nelson, a mother of six --- she has three boys and three girls --- said she plans to remain a patient at Mile Square, although Nelson and her husband, Lionel, live 40 minutes away in Crete, a suburb south of Chicago.

The 32 year-old Nelson, who lived in a neighborhood near an older Mile Square facility, said she initially went there because she received friendly help with prenatal care and breast feeding from the physician, the nurse and the nurse-midwife regarding natural childbirth. Nelson gave birth to all of her children at the University of Illinois Hospital in Chicago.

Dr. Winn said LaGroon will organize a team of experts who will visit neighborhoods to discuss Mile Square, which offers a variety of services in one place, including an on-site pharmacy.

One place to go to meet all of your health needs
Dr. Winn believes offering comprehensive services in one location will benefit poorer patients who have to rely on public transportation.

"Patients don't have to make multiple appointments at different locations to get themselves taken care of," Dr. Winn said. "You can see your primary care doctor, visit a specialist and pick up a prescription—all in one place, in a single visit. Patients whose needs extend beyond Mile Square can all be referred for care at the UI Hospital, two blocks away."

The new center's first floor houses mammography, optometry and pharmacy services, with an on-site laboratory for medical tests. The urgent care center, with access to X-ray and ultrasound imaging also will be on the first floor. Urgent care's hours are from 11 a.m. to 9 p.m. Monday through Friday and 10 a.m. to 6 p.m. weekends and holidays.

The clinic has 43 examination rooms on the second floor for primary care, family medicine, pediatrics, obstetrics and gynecology.

Dr. Robrt A. Winn
Dr. Robert A. Winn, associate vice president for community-based
practice at UI Health, talks with Ja-Niece Nelson, a Mile Square patient.
(University of Illinois photo)
There also will be two telemedicine rooms to connect patients with off-site psychiatric specialists.  The second floor also has a bariatic room for treating surgically the morbidly obese that is fitted with a door that is 45 inches wide, compared to a regular 41- or 42- inch wide door.

The center's third floor will house dental services. The fourth and fifth floors will likely serve as offices for community-based research and education. The sixth floor is a utility closet.

The staff includes physicians, nurse practitioners and nurse midwives, and residents. Obstetrical and gynecological care, which will include mammograms for women, will be readily available.

Mammograms will be an especially important service to black women who are diagnosed with high rates of breast cancer because they don’t get mammograms on a regular basis.

Patents also can see specialists in ophthalmology (diseases of the eye), psychiatry, otolaryngology (ear, nose and throat), endocrinology (sub-specialty of internal medicine), pulmonology (specialty dealing with disease of the respiratory tract) and cardiology (specialty dealing with the heart).

The 12 other older Mile Square health centers are located throughout Chicago and Cicero, a suburb west of Chicago.  

Mile Square will host a ribbon-cutting ceremony January 21 at 5:30 p.m. in the health clinic located at Roosevelt Road and Wood Street.

Here is Mile Square’s website.

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