The Caroline Street Clinic for the Uninsured will be closing its doors at the end of this year due to a number of unresolved problems with patient care and practical operations.
The clinic was open on Monday and Tuesday evenings from 6 to 9 p.m. and saw about 40 people per week. Its focus was to help patients manage chronic conditions like high blood pressure, diabetes and asthma. One of the primary ideas behind its founding was to make general medical treatment more easily and cheaply obtainable for citizens who might otherwise have ended up in emergency rooms.
Located in East Baltimore, the clinic was a project funded and run by the Johns Hopkins Urban Health Institute (UHI). It opened in November, 2004 to provide basic primary care free of charge to patients without health insurance. The facility was staffed entirely by professional and student volunteers from the Hopkins system. Around 40 percent of people seen were Hispanic, and the clinic became a prime opportunity for students interested in bilingual health care to gain experience with non-English speaking patients.
The project reported through Steven Knapp, provost, to President Brody. When it was moved under the school of Public Health, Robert Blum became interim director of UHI. Blum felt that a clinical operation should not be run through the school of public health and that another home for it be found. As this
pursuit was unsuccessful, the decision was made for closure.
Blum stressed that a clinic should only be run under a medical institution where patients would more appropriately be offered 24/7 comprehensive care.
Miriam Alexander, the clinic's managing physician, explained that the clinic was part of a "safety net" of low-income health care providers. The overarching goal is to make quality health care accessible to everyone.
"We feel we've played a valuable albeit small role in East Baltimore in helping people get primary care, an un-met need. We feel that we are really providing a service, and we feel that we've been excellent place for students to learn here -- including nursing, medical, and undergraduate students. And because several of the clinic's population are Hispanic, [it is] a very good place to train in speaking Spanish, especially for physicians and nurses and nurse practitioners," she said.
There were, however, significant obstacles from the time of its opening. Most of them stemmed from the fact that the clinic, as part of the Urban Health Institute, was under the administration of the School of Public Health. This means that it was not under the direction of a medical institution.
As a result, Blum explained, "There were no mechanisms for referral, laboratory tests were done on a very limited basis, and sub-specialty care was simply not available."
Additionally, the clinic's limited hours made it impossible for patients to receive more comprehensive care, and for many the only other alternative was still the emergency room.
In this transitional period, staff members are working closely with the East Baltimore Medical Center and other facilities to ensure that patients will be taken care of elsewhere.
"We certainly hope it's true that they can go elsewhere. We believe the reason patients come to our clinic is because others did not meet their specific needs. Many of our patients are almost exclusively adults in East Baltimore, we've been helping them manage chronic conditions that do not have tangible pain or symptoms like high blood pressure but the challenge is that many other clinics have barriers that have made patients feel like they can't access that care," she said.
"For those who can't afford even the minimal level of cost sharing that they would be asked to pay, the Urban Health Institute is committed to underwriting those visits so that literally none of our patients, independent of their financial means, would be denied health care," Blum said.
"The East Baltimore Medical Center has been very gracious about working with us," Alexander said.
