Free Health Care for Bronxites

By Rayna Tamko

Jonathan Hernandez lined up an hour before the Einstein Community Health Outreach Free Clinic (ECHO) opened its doors at 8:30 am, hoping to cut down the wait time. “There’s always a long wait so you have to be ready to spend your whole Saturday here,” said Hernandez, 28. “I have to wait five hours to just have someone read me my lab results.”

ECHO Clinic is a free clinic serving uninsured people over the age of 18. The clinic does not see children because as of January 2014, all children in the state of New York are eligible for insurance under Child Health Plus. The clinic is located on Walton Avenue in the South Bronx and is only accepts clients on Saturdays until noon. The 15th is the poorest congressional district in the country with 32 percent of its residents living in poverty, according to the American Community Survey. This population suffers from significantly worse health outcomes than wealthier parts of the city. Its residents experience high rates of asthma, diabetes and infant mortality.

ECHO was the first student-organized clinic in New York and the doctors that see the patients are third and fourth-year students at Albert Einstein College of Medicine that work under the supervision of an attending physician. Students volunteer at ECHO as part of their third-year family and social medicine rotation. “Our curriculum teaches us the importance of working with medically underserved communities and ECHO allows me to experience it,” said Michael Chee, a third-year medical student at Albert Einstein. Since Einstein is located in the Bronx, a primary focus is placed on practicing in medically underserved areas.

On a typical Saturday at ECHO, patients usually start lining up at 7:30 AM to ensure that they secure a visit. Once the doors open at 8:30 AM, patients sign in on either a walk-in sheet or an appointment sheet. Then patients are given forms to fill in order of when they arrived. The first patient is usually called back at around 9:30 AM.

For many patients, free clinics like ECHO are their only option to get access to healthcare. “I can’t start my new job until I get health clearance, but I don’t have insurance until I start so this clinic is really helpful,” said Raquel Moore, 23, a first-time patient at ECHO clinic. Appointments are often booked far in advance, but the clinic accepts a limited number of walk-ins each Saturday. “They told me to get here early and put my name on the list, but they kept telling me that there is still a chance that I won’t be seen,” said Moore. After a three-hour wait, Moore was called into an exam room.

ECHO takes a comprehensive approach to healthcare by providing general exams, referrals to specialists and mental health services. Volunteer translators are on site each Saturday to ensure that each patient can communicate with his or her healthcare provider. Each patient is required to see a social worker that provides help with free prescription cards, insurance applications and counseling. On select days of the month, a civil surgeon – a doctor authorized by the U.S. Citizenship and Immigration Services — performs the medical exam required for green card applicants. The South Bronx is food insecure which is “the state of being without reliable access to a sufficient quantity of affordable, nutritious food.” To address this, ECHO distributes free fresh produce along with healthy recipe ideas each Saturday.

The mission at ECHO is to ultimately transition patients into permanent care at either the weekday clinic in the same building or one of the other clinics operated by the Institute of Family Health. If the patients are still uninsured after applying with the social worker, they are put on a sliding scale and only asked to pay what they can depending on their income. Patients are never turned away for inability to pay or sent to collections. Patients that come to ECHO are granted two visits before they are transitioned to more permanent care. “Every patient that comes here sees a social worker at the end of their visit where we help them learn about their options for insurance and help them find a primary care physician,” said Marlyss Gomez, 37, a social worker at ECHO Clinic. Patients with chronic conditions such as diabetes or hypertension get four visits. Social workers also provide cards that allow patients to get their prescriptions filled for free at a pharmacy affiliated with the clinic.


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