MedStar Union Memorial Hospital - Shepherd's Clinic

Overview

In 1991, in partnership with Baltimore’s Seventh Baptist Church, MedStar Union Memorial Hospital (UMH) opened a primary health care clinic to provide services to uninsured residents of northeast Baltimore. Originally located in the basement of a house owned by the church, the clinic has moved to larger facilities where volunteer health care professionals provide primary and specialty health care to the uninsured. Over the years, the clinic has expanded to offer specialty care, mental health services, and wellness and prevention programs. Because of its affiliation with UMH, the clinic is able to provide patients with a continuum of care. Patients whose care needs escalate beyond what the clinic can provide are referred to the hospital at no cost to the patient. Those eligible for care at the clinic include uninsured working adults and unemployed residents of northeast Baltimore that have non-emergency health care needs. The clinic does not charge a fee, but they do request a donation that is equal to one hour’s wage.

Impact

Shepherd’s Clinic handles approximately 4,000 patient visits each year. Service is provided by some 250 volunteers including hospital doctors, retired doctors, nurses, and therapists. In addition, third-year medical residents spend two to four weeks working at the clinic, which provides an important training ground for medical residents. The clinic partnership eases the strain on the hospital emergency department by providing a more appropriate place for the uninsured, non-emergency patients to receive health care services.

Challenges/success factors

Through its partnership with UMH, Shepherd’s Clinic can provide patients with a full continuum of care. Eligibility is restricted to residents of UMH’s primary service area; patients from other parts of the city do not have access to this type of program. Other clinics have expressed interest in the model but have been unable to find a hospital partner that is willing to make the same commitment.

Future direction/sustainability

The vast majority of funding for the clinic is secured through grants and private donations. The clinic is working with UMH and MedStar Health to develop a hybrid clinic and fee-for-service model that will serve this patient population in the post-health care reform era.

Advice to others

This type of partnership must be integrated with an overall charity care policy that transcends the entire organization. Coverage provisions must be included in service agreements and employment contracts for hospital affiliates in the areas of anesthesia, imaging, lab, and other testing.

Contact: Jill Johnson
Assistant Vice President, Physician and Ambulatory Care Planning
Telephone: 443-377-4580
E-mail: jill.johnson@medstar.net