Trenton Health Director Pushes for Overhaul of Clinic Service to Community
by TRENTON — After years of funding cuts forced the city’s North Broad Street health center to trim its staff and significantly reduce specialized services for children, expectant mothers, people with tuberculosis and other populations, Trenton’s new health director is proposing an overhaul that he hopes will allow services to begin growing again.
Together with the Trenton Health Team, director James Brownlee said last week he is applying for federal “free clinic status,” which would provide essential malpractice insurance for a new staff of volunteer doctors, nurses and other professionals who have retired from local hospitals.
With funding still tight, the reopening of specialized clinics would happen gradually, but would eventually restore a range of services recommended under state standards, he said.
“It will all have to be staggered. We will not be able to open the clinics with every service available at one time,” Brownlee said. “What we would do is build them up over time as we bring volunteers in to work in the clinical setting. To me it is one of the most exciting things to do to restore services.”
Instead of continuing to try to treat any problem at any time, the health center would arrange open hours at convenient times for patients who need treatment for common health problems, he said. Separately, it would periodically offer specialized clinics for tuberculosis and other needs.
Support for revitalizing the clinics has come from the Trenton Health Team, a partnership among the city, St. Francis Medical Center, Capital Health System, Henry J. Austin Health Centers and a number of civic and charitable organizations.
The group has embraced the project as part of its wider effort to prevent the overuse of expensive emergency departments by expanding access to primary care, said Dr. Ruth E. Perry, executive director of the Trenton Health Team.
“We are working together with the city to provide services,” Perry said. “We believe this can be a model for the nation. We are reducing costs, improving health outcomes, and making a difference in people’s lives.”
Brownlee said he has applied to the federal Health Resources and Services Administration for free clinic status, which would provide malpractice insurance.
Once that designation is earned, the center can begin to adopt the Volunteers in Medicine model, which originated in South Carolina and is used at facilities in Cape May, Hackensack and Red Bank, and others around the country.
“We will use retired physicians, both primary care and specialty physicians, to rotate through our clinics. They will be covered by our insurance, so they will not have to cover the cost of their own malpractice insurance,” Brownlee said.
The city’s health department has set no targets for the number of volunteer doctors it need, but has already drawn interest from retirees from St. Francis and Capital Health’s facilities, Brownlee said.
“I do know just from conversations with board members of the Trenton Health Team that there has been an interest expressed at both hospitals, and previous physicians that have retired from both have said they’d be willing to volunteer their time in a clinic setting,” he said. “My feeling is we’re not going to have a problem.”
By relying on free medical talent to administer treatment, the city can once again offer all the services the state requires the clinics to provide, including tuberculosis treatment and required pediatric care, he said.
Under a new contract between Mercer County and the Trenton Health Team to provide education, screening and treatment for tuberculosis patients countywide, a case manager has been hired and tuberculosis treatment for patients across the county has been centralized at the health center, Brownlee said. Tuberculosis services are mandated by state practice standards, but the level of care that new case manager Deborah Stevens will provide has never before been offered through Trenton’s clinics, he said.
“There is no cost for the doctors. The medicines are provided through the state grant. It is a central operation down here, so that we don’t have to have people going over here for an X-ray, over there to see their doctor, and back and forth. We can do everything right here at 218 N. Broad St.” he said.
Brownlee said he is also working with the Trenton Health Team to analyze data tracking emergency room visits by Trenton residents to St. Francis and Capital Health System’s hospitals.
Early data show that uninsured patients repeatedly go to emergency rooms, where they cannot be denied care, and where their treatment costs much more than the equivalent treatment by a primary care doctor, Brownlee said.
His first priority is to look at the data on child patients, he said.
“What I am going to find in a very short period of time is, in our hospitals, how many kids are going into the emergency room, what are they being treated for, what time are they going there, and we’ll use that data to determine how to move forward,” he said.
Depending on whether or not the health center wins all the necessary designations, the goal is to reorganize the pediatric clinic at the North Broad Street center this fall, Brownlee said.
Contact Joshua Rosenau at jrosenau@njtimes.com.
About the Trenton Health Team
Trenton Health Team (THT) is an alliance of the city’s major providers of healthcare services including Capital Health, St. Francis Medical Center, Henry J. Austin Health Center and the city’s Health Department. In collaboration with residents and the city’s active social services network, THT is developing an integrated healthcare delivery system to transform the city’s fragmented primary care system and restore health to the city. THT aims to make Trenton the healthiest city in the state. Support for the Trenton Health Team was provided in part by a grant from The Nicholson Foundation. For more information, visit www.trentonhealthteam.org.
