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An outpatient clinic operated by Evanston Hospital, 2500 Ridge Ave., is narrowing the geographic area from which it will accept new patients, J.P Gallagher, president of the hospital, told the RoundTable.

At the other end of town, St. Francis Hospital, 355 Ridge Ave., transferred ownership of its outpatient clinic located at 7464 N. Clark St. to Access Community Health Network.

A common theme is the escalation in demand for services at free and discounted fee outpatient clinics as a result of the economic downturn.

Evanston Hospital’s Outpatient Clinic

Evanston Hospital’s outpatient clinic, which has been in place for 25 years, provides free and discounted fee outpatient care to adults, children and adolescents who lack private insurance. It provides primary care, as well as specialty services, such as orthopedic, GI, oncology and other specialty services, to its patients. The clinic’s patients who need inpatient hospital services may be admitted to Evanston Hospital, said Mr. Gallagher.

The primary purpose of the clinic is to provide charity care, said Mr. Gallagher. He said it also serves the hospital’s mission of teaching doctors in that it is used to teach residents in an outpatient setting.

Last year the clinic served about 13,000 active patients, who had about 21,000 patient visits, said Mr. Gallagher. The patient base is up from 7,000 two years ago, a 70 percent increase. The patient base has increased to where new patients have to wait as long as four months for an appointment, said Mr. Gallagher. Most of the patients are residents of Evanston.

Mr. Gallagher said Evanston Hospital decided to narrow the geographic boundaries of its clinic because the clinic has reached its capacity, and the hospital wanted to ensure that the clinic would have the capacity and ability to serve Evanston residents.

The clinic’s south boundary has been changed from Peterson to Howard Street. The west boundary has been changed from Route 83 to about I-294. This returns the south boundary to where it was five years ago for adult patients, said Mr. Gallagher.

He emphasized that the hospital is not reducing staff at the outpatient clinic or reducing its commitment to the clinic. When asked why the hospital did not increase the staffing levels at the clinic to accommodate the new patients, he said the clinic had reached capacity.

Existing patients who live south of Howard or west of I-294 will continue to be served at the clinic. Prospective patients, however, who live outside the new boundaries, will be given the name of another health-care provider to serve their needs, Mr. Gallagher said.

The impact on persons in Rogers Park will be small initially because exiting patients will continue to be served at the clinic, said Mr. Gallagher. Between 500 and 700 persons from the Rogers Park area are current patients of the clinic, he said, which may give some indication of the impact in the future.

Evonda Thomas, director of the City’s Health Department, told the RoundTable that the increase in the number of patients at the outpatient clinic “created a burden for our own residents, because the increase decreased access to the clinic. It was a hardship for them to wait four months.”

She said Evanston Hospital’s redrawing the boundaries because of the increased patient load “speaks to the need for us to have our own health-care clinic.” She said she was glad that both Evanston Hospital and St. Francis Hospital “are working with us to establish a Federally Qualified Health Care (FQHC) facility in Evanston.”

An FQHC must accept all patients without regard to ability to pay for the services. In exchange for that commitment, the FQHC receives federal grant funds and Medicaid payments under a special formula.

Cook County Commissioner Larry Suffredin expressed concern about the boundary changes of Evanston Hospital’s outpatient clinic, and the impact it may have on low-income households in Rogers Park. He told the RoundTable he thinks there is a need for additional FQHCs to meet the needs of low-income households and uninsured persons.

St. Francis’ Transfer Of Its Outpatient Clinic

Last month, St. Francis transferred ownership of its outpatient clinic at 7464 N. Clark Street in Chicago to Access Community Health Network (Access). Evelyn O’Connor, a spokesperson for the hospital, said physicians and residents from St. Francis Hospital will continue to provide services at the clinic, and patients of the clinic may be referred to the hospital for inpatient services, but the clinic will be operated by Access.

She said the clinic will provide more flexible scheduling, and patients will have access to more specialized services and a wider breadth of services under Access.

Access, an FQHC, operates more than 50 community health centers in underserved, low-income neighborhoods throughout the Chicago area. According to its website, it provides primary care services to more than 215,000 persons in the Chicago area, and last year provided care in almost 600,000 primary care visits.

Access Chief Executive Officer Donna Thompson told the RoundTable that Access opened an outpatient clinic at 1555 West Howard St. 13 years ago and expanded the facility three times to accommodate patient growth. Last year the Howard Street clinic had 20,000 patient visits. She said Access is committed to continuing to operate the Howard Street clinic as well as the one it just took over from St. Francis on Clark Street just north of Touhy Avenue.

She added that Access has a long relationship with St. Francis and that St. Francis has been “very supportive of our mission.”

When asked if the boundary change of Evanston Hospital’s clinic would impact Access, Ms. Thompson said many families have lost their jobs, lost their health insurance, and are struggling to keep a roof over their head and food on the table. Many people are afraid they do not have a place to go for outpatient health-care services, she said.

The need for outpatient services to serve low-income and uninsured households has substantially increased, she said.

Ms. Thompson said 54% of Access’ patients are on Medicaid, and 20% are self-pay, and the payments received from Medicaid and self-pay patients do not cover the cost of providing them services. “There’s really no margin, really no funding to offset the cost” to provide care to these patients, she said. When a portal to access closes, “it has a tremendous affect on us, as well as St. Francis,” she said.

She said, “Your ability to be accepted by a health-care provider shouldn’t be determined by the card you present to the front desk.