Dr. Lee Francis, president and chief executive officer of Erie Family Health Center, at a panel discussion in Evanston on March 2. RoundTable photo

Erie Family Health Center in Evanston (Erie Evanston/Skokie) has grown from a start-up clinic operating out of the City’s Civic Center in October 2012 to serving 6,500 patients, with 17,500 patient visits in the last year.  Its state-of-the-art facility at 1285 Hartrey Ave. has 15 patient exam rooms and five dental suites.

About 41% of Erie Evanston/Skokie’s patients live in Evanston, 17% are from Skokie, 14% from Rogers Park, and the balance from other neighborhoods in Chicago or other suburban areas.

Erie Family Health Center (Erie) has been serving patients in Chicago for nearly 60 years, Dr. Lee Francis, president and chief executive officer of Erie, told a gathering of about 40 people on March 2 at the Evanston/Skokie facility. Erie currently serves about 70,000 patients in 13 locations. Evanston is its first suburban facility.

“We not only have 13 locations,” said Dr. Francis, “but we have first-tier quality. We really believe that health care is a right for folks, and also that they should have top-quality facilities and top-quality health care as well.”

Erie is rated a “Federally Qualified Health Care Center” and was recently named a Health Center Quality Leader  by the U.S. Health Resources and Services Administration, which places it in the top 2% of health centers in the country, said Dr. Francis.

A Mission to Serve All

All of Erie’s health facilities provide services to their patients regardless of ability to pay. Erie focuses on “a low-income population,” said Dr. Francis. He said 98% of Erie’s patients have incomes less than twice the federal poverty rate, which is about $48,000 a year for a family of four.

“If you are at that income and you don’t have insurance, we will slide your fee down to a very affordable fee. We will never say, ‘No’,” said Dr. Francis.

About 86% of Erie Evanston/Skokie’s patient visits are with Medicaid patients and 10% are with uninsured patients. About 20% of the patients speak a foreign language, with Spanish being the primary one. “We require our staff to be bilingual,” Dr. Francis said.

“We treat every patient with a great deal of respect,” said Dr. Jennifer Colleton, a pediatrician and internist at Erie Evanston/Skokie who grew up in Evanston. “We know them as partners.”

The Range of Services

Erie Evanston/Skokie has 11 doctors (some part-time) and one advanced practical nurse on staff. They offer a full range of services, including prenatal and delivery, pediatric, breast and cervical cancer screening, women’s health, internal medicine, behavioral health and health education.

The clinic also provides dental care for children and pregnant women.

Dr. Avery Hart, medical director of Erie Evanston/Skokie, said the clinic also provides access to secondary or tertiary care services through contracts with NorthShore Evanston and Presence St. Francis hospitals, for example for patients with a torn ACL, or patients who need to see a cardiologist.

Under the contracts, Dr. Hart said, each hospital will see a patient of Erie with “no questions asked.” If the patient has no money, “there will be essentially no charge.” If the patient is covered by Medicaid, “they will accept the patient even if the practice does not normally accept Medicaid patients.

“The tight linkage that we have with our hospital partnerships allows us to leverage these tertiary services and save lives,” said Dr. Hart.

He added that Erie Evanston/Skokie also has full time health educators at its facility, that it provides education sessions on nutrition, and has a demonstration kitchen. It also has a running club, where patients and staff run together.

“There’s a lot of wrap-around. It’s not just about what the doctors are doing in the office, but it’s the full spectrum of education and a healthy lifestyle.’”

Erie Evanston/Skokie also has partnerships with School District 65, with the school-based health center at Evanston Township High School, and with the Childcare Network of Evanston.

“The community is rich in social services,” Dr. Hart said. “We want to build those bridges so we can access those resources for all of our patients.”

Disturbing Trends and Erie’s  Response

Dr. Colleton pointed to two disturbing trends, an increase in child obesity and an increase in child mental health issues, and she summarized how Erie Evanston/Skokie was responding.

“Obesity is at the center of good health,” Dr. Colleton said. It can lead to diabetes, hypertension, cardiovascular disease, and other diseases.

Previously, children who were diagnosed with diabetes generally had Type I diabetes, she said. But now, 45% of all diagnoses of diabetes in children are Type II. “So that’s an overwhelmingly big concern.”

Some of these children need aggressive intervention, such as education about their diets, lifestyle changes, and supervised exercises. Erie Evanston/Skokie has a health educator who meets with the whole family and discusses how the child and family can address the issue. McGaw YMCA and the YWCA Evanston/Northshore offer discounted memberships to patients of Erie Evanston/Skokie to use their facilities. Patients can access specialized services through Erie Evanston/Skokie’s hospital partners.

Another trend is the increase in children’s mental health issues, including Attention Deficit Disorder, behavioral issues, and suicidal tendencies, said Dr. Colleton. “Mental health is the foundation on which all other health is built. If your mind isn’t healthy, your body won’t be healthy either.”

Erie Evanston/Skokie is partnering with Metropolitan Family Services to provide mental health services to its patients. It has also hired a psychiatrist who will see both children and adults.

“We’re actively seeking community collaborations to build and enhance our ability to access mental health services for our kids,” she said.

‘Reach Out and Read’

In an effort to promote early childhood development, pediatricians and other doctors at Erie Evanston/Skokie participate in the Reach Out and Read program, which is designed to encourage parents to read aloud to their children.

Dr. Aimee Crow, a pediatrician at Erie Evanston/Skokie and a hospitalist at NorthShore Evanston Hospital, said under the program doctors give families who bring in their children, ages 0-5, an age-appropriate book and help them understand the importance of reading aloud to their children. They also give parents suggestions on ways to interact with their children while reading.

The program is endorsed by the American Academy of Pediatrics and has had positive results. See “Erie Family Health Center Helps Build Young Minds Through Reach Out and Read Program,” available at evanstonroundtable.com for more information.

Reaching Capacity/Aspirations

Evanston Erie/Skokie is reaching capacity. “I will project in about a year we’ll be a little bit busting at the seams, trying to find more evening hours, possibly weekend hours to try to maximize use of our square footage,” said Dr. Francis.

He said as part of the planning process in 2010, Erie acquired a right of first refusal on space which connects to the existing facility. If Erie takes over that space, it “can double the capacity,” he said.

Going forward, Dr. Francis said, “I think we really want to make sure we’re reaching all communities that need our services in the best way we can.” He said he would like to expand the facility by taking over the adjacent space and to keep the clinic open for additional hours that are more convenient to working parents.

He added that he would like to take advantage of any opportunities to partner with the members of the community. “That’s our most aspirational thing. That’s going to make us the most successful.”

Erie, a 501(c)(3) organization, depends on private grants and donations for 13% of its funding.