After-Hours Clinic

Grantee: Country Doctor Community Health Centers
Timeframe: July 2014 – June 2015 | Total Amount: $553,958

Year 1: July 2014 – June 2015. Amount: $163,958
Year 2: July 2015 – June 2016. Amount: $190,000
Year 3: July 2016 – June 2017. Amount: $200,000

CDCHC has been providing health care to the people of Central Seattle (and beyond) for almost 43 years. Late in 2013 CDCHC opened an after-hours clinic in partnership with Swedish Medical Group. Swedish is providing the facility (the family medicine residency clinic at their Cherry Hill campus); the cost of operating the clinic (salaries, supplies, administrative support) is borne by CDCHC. Although 43% of the individuals seen since the clinic opened on 12/2 are uninsured, CDCHC currently does not receive any grant funding to support this operation. To date the After Hours Clinic is running a deficit of $103,385. This is clearly not sustainable.

The second patient seen at the AHC illustrates the importance of this clinic. After a three day bus ride from California an uninsured, Hispanic, single mom and her 8 year old daughter came into the clinic. The child had been vomiting for two days. Being new to town she went on the Internet and was directed to the After Hours Clinic where the child was diagnosed and treated. Had the After Hours Clinic not been in operation the mom would have had to take her child to an emergency room where she would have been charged significantly more than the $20 she paid CDCHC. Untreated the child could have become dehydrated, a condition that could have resulted in hospitalization – a significant cost for the health care system as a whole.

For the time period between 12/2/13 and 1/22/14 444 individuals were seen. It is anticipated that as word of this clinic spreads the number of patients will increase; for 2014 CDCHC anticipates providing 7,500 visits. Patients are generally seen in the after-hours clinic once then referred on to a more permanent medical home for on-going care, including chronic disease management and preventive care. For this six week period the patients seen in the after –hours clinic were:

• Uninsured (43%)
• Low Income (56% earned under 100% Federal Poverty Level, another 23% under 200%)
• People of color (47%)
• An additional 10% were homeless.

The need for this service is illustrated by the wide range of residence.

• 28% lived in Central Seattle (zip codes 98102, 98112 and 98122),
• 27% traveled from areas of King County outside Seattle city limits, and
• 6% lived outside King County.
• The remaining patients came from a geographic area ranging from Shoreline to Tukwila and Skyway.
• A significant number came from other Seattle neighborhoods such as Columbia City, Beacon Hill, the Rainier Valley, Greenwood, the University District, Pioneer Square and the International District.

Only urgent, not emergent care, such as diagnosis and treatment of the flu, strep throat, fractures and urinary tract infections is provided; the clinic is located immediately next door to the Cherry Hill Emergency Room, where patients needing true emergency care are referred.