THE VIRGINIAN-PILOT
Copyright (c) 1997, Landmark Communications, Inc.
DATE: Friday, January 24, 1997 TAG: 9701220132
SECTION: PORTSMOUTH CURRENTS PAGE: 08 EDITION: FINAL
TYPE: Cover story
SOURCE: BY REBECCA MYERS CUTCHINS, STAFF WRITER
LENGTH: 173 lines
SOON AFTER ERICA ASH gave birth to her daughter Brittany two months ago, the baby developed a rash on her face.
Unemployed and uninsured, Ash knew she wouldn't be able to afford the necessary visit to a pediatrician's office.
Then she remembered being told about a place that provides affordable health care for people who have little or no insurance.
``When I delivered her, a nurse in the nursery told me about this place,'' said Ash, 23, as she sat cradling her infant in the waiting room of the Portsmouth Community Health Center.
Next to Ash, a sign on a wall reads: ``You will not be denied services based solely on lack of income.''
Those are comforting words to Ash, a Medicaid recipient who was recently laid off from her part-time job in Chesapeake at a flower-packing plant.
``Her next appointment is in March for her shots,'' said Ash, after her daughter was seen by the center's pediatrician.
``But we'll be coming back in the next two weeks to check on her rash.''
Since the Portsmouth Community Health Center opened 20 months ago at the corner of Seventh and Lincoln streets, nearly 4,000 low-income patients have passed through its doors.
According to John E. Schalk, the center's executive director, about 42,000 residents of Portsmouth are uninsured or have Medicaid, a government program that covers health-care costs for the poor.
With federal grant money, the Portsmouth Community Health Center opened in May 1995 to serve those who, because of their financial situations, receive little, if any, medical attention.
``We're here to see a population that was not pretty much being seen before,'' said Schalk.
Before the center opened, low-income families sought medical attention at a small adult-care clinic at the Portsmouth Health Department or at the Elm Avenue Center for Health (EACH), a health-care facility set up in a wing of Martin Luther King United Methodist Church.
``Other than that, I'll be totally honest with you, people used to not go anywhere, and get so sick they'd wind up in the emergency room,'' Schalk said.
About 42 percent of the center's 3,771 patients come from the downtown area. The center tracks its patients by zip code. Nearly 20 percent come from the 23701 area, which includes Simonsdale, Park Manor, Hodges Manor and Cavalier Manor; another 14 percent live in 23707, which includes Port Norfolk and the Midtown area; and the remaining 15 percent come from the rest of Portsmouth, which includes Cradock and Churchland. Only 9 percent are from outside Portsmouth.
``We've exceeded 600 visits per month since about October,'' Schalk said. ``In fact, this month was our busiest month so far ever, and we expect to be well over 700 visits this month.''
Most patients come in with acute illnesses like colds, flu or strep throat, or chronic illnesses like hypertension and diabetes. The center also does routine pelvic exams and Pap smears. A family physician, pediatrician and nurse practitioner are the center's three full-time providers.
With a pediatrician on staff, the center is able to offer well-baby checkups, as well as a full range of pediatric services, such as immunizations. About 96 percent of the center's youngest patients are up to date on all their vaccines.
``With a family physician and a pediatrician practicing together, they can cover the whole gamut from newborn on,'' Schalk said.
The center does not offer obstetric care, although it does provide pregnancy testing. All HIV-positive patients are referred to the Portsmouth Health Department, which offers specialized treatment for the virus that causes AIDS.
``The only business we've taken away from anybody is from the emergency rooms at the hospitals, and they want us to do that,'' Schalk said. ``Emergency rooms are not the place for someone to go with a strep throat.''
The 9,400-square-foot facility has 12 examining rooms, nine of which are currently in use. It also has a public meeting room, which is used by community groups for health-related activities, and an education room for patients to learn more about health and wellness.
An initial fee of $5 is charged, then patients pay based on their incomes. The sliding fee scale takes patients' family size and annual income into account.
The poorest of patients may qualify to get all of their care for a mere $5. ``That's not $5 down and you owe us the rest,'' Schalk said. ``That's $5 period. They don't get billed for the balance.''
Those who are a little better off may be required to pay a percentage of the bill.
The center also accepts Medicare and Medicaid. Medicaid patients are exempt from any minimum payments.
But, Schalk warned, the Portsmouth Community Health Center is not a place for everybody in Portsmouth to come and get free care.
``If someone comes here with all the money in the world, they would wind up paying a bill just like they would at any other doctor's office.''
About 45 percent of the center's funding comes from federal grants. An application for a $449,000 grant is made every 12 months. The rest of the center's money comes from revenue from Medicare and Medicaid, as well as fund-raisers and donations.
``We have been supported by two local foundations very, very nicely - the Maryview Foundation and the Portsmouth General Hospital Foundation,'' Schalk said. ``They've both been very generous in their support of the center.''
The center is dependent on donations, which are tax-deductible. Brass nameplates and plaques bearing the names of benefactors dot the walls of the facility.
Recently, the Portsmouth Academy of Medicine Alliance bought a new EKG machine for the clinic. But most equipment - from heart monitors to examination tables - are ``hand-me-downs'' from Portsmouth physicians.
Doctors from the Portsmouth Academy of Medicine also volunteer at the facility and donate medicine.
``Many of our local doctors will call us up and say, `We have extra samples if you can use them,' so we can give somebody a two-week supply of antibiotics,'' Schalk said, ``and it doesn't cost anybody anything.''
Drug companies also provide free medicines through their indigent drug programs. Through one such program, the center has been able to give $41,000 worth of free medication to patients since July.
Although the center has not yet received any funding from the city, Schalk said he is hoping to be included in the city's budget for next fiscal year.
``Mayor (James) Holley has been very supportive,'' Schalk said. ``As you know, he's a health-care provider himself, and he has been very, very active in health care issues since he became mayor again.''
Formerly a Be-Lo supermarket, the Portsmouth Community Health Center shares space with a barber shop and a restaurant in a small shopping center called Southside Plaza in the 600 block of Lincoln Street. At least two other spaces are vacant and are available for lease.
Before the health center opened, Schalk said, Portsmouth Police Chief Dennis Mook suggested that the landlord follow a few safety recommendations: grant no liquor licenses to any new businesses, provide no outside pay phones, and install bright lights in the parking lot.
``We've done a lot to take a little section of the city, which was not in such good shape, and turn it into a productive area instead of the eyesore that it was,'' Schalk said. ``And it's worked. We've not even come close to an incident.''
The center employs 19 people, including nurses, lab technicians, nursing assistants and administrative support.
The center has been growing by about 200 new patients a month, said Schalk.
Most patients hear about the center through word of mouth or through referrals by emergency room physicians and the Portsmouth Health Department.
But before the health center posted a sign outside with the names of its medical professionals, curious visitors would occasionally venture inside the center to ask about it.
Said Schalk: ``We actually had somebody go by and see the sign for `Portsmouth Community Health Center' and say, `Oh, that's a health center. That's where you do aerobics and visit the sauna, right?' '' ILLUSTRATION: Staff photos, including color cover, by MARK MITCHELL
Erica Ash, 23, brought her 2-month-old daughter, Brittany, to
Portsmouth Community Health Center. Ash, who is unemployed and
uninsured, learned about the center when Brittany was born. They
will be returning to the center for followup visits.
Erica Ash holds her daughter, Brittany, during a visit to Portsmouth
Community Health Center, as Pat Linanag makes notes on the baby's
chart.
John E. Schalk, the executive director of the health center, says it
serves ``a population that was not pretty much being seen before.''
Most patients are seen for colds, flu or strep throat, or acute
illnesses like hypertension and diabetes.
Graphic
ABOUT THE CENTER
Location: 664 Lincoln St.
(at Seventh Street)
Number: 393-6363
Hours: 9 a.m. to 5 p.m. Monday, Wednesday, Thursday and Friday,
and 11 a.m. to 7 p.m. Tuesday.
What's offered: Family-centered comprehensive health care,
including laboratory services, pharmaceutical support, office
procedures, and health and wellness programs, all on a sliding fee
scale.
Cost: A minimum fee of $5 is required, then patients pay based on
their incomes. The center accepts Medicare and Medicaid.