SERVING THE MEDICALLY UNDERSERVEDProviding Quality Healthcare for Low-Income Patients is Passion for UIC SPH GradDr. Lee Francis can remember seeing Cook County Hospital out of the back window of the family station wagon when he was a boy. His parents told him that it was a place where anyone could go for medical care, regardless of their ability to pay.
“Geez,” Francis thought, “I’d like to be part of that some day.”
Francis, who received a Masters of Public Health from the UIC School of Public Health in 2000, said his life-long belief that every human being has a right to the best health care that modern medicine can provide, eventually brought him to the Erie Family Health Center, where he currently serves as President and CEO.
The Erie Family Health Center provides comprehensive primary care services at eight health center sites to over 30,000 low-income patients per year, regardless of ability to pay. Erie’s patient population is 87% Hispanic; 70% of the adults are uninsured; 81% live below 100% of the federal poverty level; and 82% are best served in Spanish.
Services provided at Erie include pediatrics, internal medicine, family medicine and women’s health. In addition, Erie provides HIV/AIDS care, behavioral health, case management services, health education (asthma, diabetes, nutrition, parenting and prenatal) and oral health services.
Francis joined Erie Family Health Center as an Internist in 1991. Before training in Primary Care Internal Medicine at Cook County Hospital in Chicago, he received his medical degree at the UIC College of Medicine. Prior to assuming his present position, Francis spent ten years dividing his time between Cook County Hospital, and Erie.
“In my training at UIC and in many of my clinical rotations at Cook County, I was exposed to wonderful role models in medicine and public health,” Francis said. “To them, health care was part of civil rights, and I guess I strongly ended up believing that too.”
While Erie has grown by 70% over the last five years, the number of uninsured has also risen in the Chicago area. Almost 50 percent of the medically underserved in Chicago reside in Erie’s service area and the numbers continue to rise.
“Here in our own backyard, 1.3 million Chicago-area residents are uninsured, and one out of three of the city’s uninsured is Hispanic,” Francis said. “At Erie, we know from experience that ‘one out of three’ isn’t just a statistic. It’s a life that’s being compromised by a lack of access to medical care.”
In Erie’s service area, 25% of women do not enroll in prenatal care in their first trimester, which is nearly double the amount of women in all of Chicago. Babies of mothers who receive no prenatal care are three times more likely to be low birth weight and five times more likely to die, Francis said. In Humboldt Park (in Erie’s service area), the infant mortality rate is almost twice the rate for Chicago, he said.
Diabetes ranked in the top 10 leading causes of death for persons in Erie’s service area and is at epidemic levels in Humboldt Park, where one of Erie’s health centers is located. Uninsured adults are unable to manage their condition because of frequent health crises, difficulty getting medications, poor understanding of their illness and little knowledge of self-care or risk factors, Francis said. Erie’s Diabetes Care Program provides chronic disease management care including medical care, health education on nutrition, physical activity, foot care, and necessary diagnostic services.
Erie’s Oral Health Program cares for children and pregnant women to provide comprehensive oral health services and oral health education. 70% of children under 12 in Erie’s service area do not have a dentist, nearly 50% of children had not seen a dentist in over six months and 52% of children currently had a dental problem, Francis said.
“At Erie, we are looking at innovative ways of combining oral health and medical care, which is very important in the underserved community” Francis said. “For example, if a mom brings her child here, the pediatrician will deliver an oral health message appropriate to the child’s age. If a woman is pregnant, the obstetrician or midwife will tell her that every woman should see a dentist in her first trimester because of the link between oral care and health.”
Since so many of Erie’s patients live below the poverty level, the organization charges a flat-fee of $30 per visit for uninsured patients; however they collect only $19-$20 per visit. Erie’s average cost per visit is $150, Francis said.
Despite the fact that Erie collects only a fraction of their costs from patients, the organization boasts state-of-the-art medical facilities and an electronic health record system.
“If you look at community health centers nationwide, in many cases we provide better care than the average private practice,” Francis said.
Francis credits much of his passion for helping the medically underserved to both his many mentors at the UIC SPH, such as Dr. Victoria Persky, and to his parents.
“My parents raised my sister and me to be alert, awake and aware to what is going on in the world, so I had sort of a spark for this thing before med school,” Francis said.
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