Almost every person there was waiting to be treated for the flu.
“You don’t need to go to the emergency room for the flu,” said Lee, executive director of the Saratoga Hospital Foundation. “You need to be seeing a primary care physician.”
The ever-present problem of uninsured patients seeking medical care through the emergency department of Saratoga Hospital is one of the main reasons it decided to open up a Community Health Resource Center (CHRC), a medical facility that will cater toward people who are uninsured or underinsured and need a place to receive primary health care.
“Emergency departments have a tradition of becoming a provider as a last resort for a lot of people,” said Angelo Calbone, CEO of Saratoga Hospital. “It’s one of the few services you can use in health care where you don’t need prearranged physician’s orders, so a lot of people will use the ER as a source of health care and it’s not a good source of health care.”
Calbone added that more people use the emergency department than most people think due to a New York law that states emergency rooms can’t turn away patients, even if uninsured.
“It’s not in the hundreds of thousands, but it’s every day,” Calbone said. “There are a number of people that use it regularly as their point of primary service. It’s inefficient for the system and it’s not great care for them—it doesn’t get them into the system properly so a physician can say, ‘I see this going on, let’s bring you back in five days and see how this is going,’ or ‘Try this medicine and see if it controls your blood pressure a little better.’”
Lee said the CHRC will try to educate patients on when it is and isn’t appropriate to use the hospital’s emergency department.
“It’s important that the community understands the purpose of this center,” Lee said. “You do not want to go there if you live downtown and suddenly have a heart attack—you still want to come to the emergency department. But if you are aching all over and think you have the flu, [the center] is where you go, and we’ll try to get you to build a relationship with the doctor who is there.”
The CHRC will be headed by Dr. Sri Tumuluri, a primary care physician who will take on the role of medical director for the center. Dr. Tumuluri originally attended and received a Bachelor’s degree from the Wharton Business School at the University of Pennsylvania before deciding to pursue a career in medicine.
“This is my lifelong interest,” Dr. Tumuluri said. “That’s why I became a doctor and I pursued [this opportunity] and it turned out to be this great fit, so I’m absolutely thrilled.”
After completing a primary care residency at New York Presbyterian Hospital in Manhattan, Dr. Tumuluri worked as a hospitalist at Albany Stratton VA Medical Center providing in-patient care for people with illnesses that keep them in the hospital for an extended period of time.
“Every time I see these patients at the VA that are so sick, I wonder why someone didn’t intervene a few weeks ago so they don’t have to be so sick now,” Dr. Tumuluri said. “So now I get a chance to try.”
The CHRC, along with trying to build relationships between patients and doctors, will also provide dental care and a “patient navigator” who will help new patients through the process of paperwork and finding other resources they may need. Calbone said patients may come in and be eligible for the Child and Family Health Plus program, Medicare or Medicaid programs and can use the patient navigator to help them see if they qualify.
“If someone comes in that has no coverage whatsoever but has the ability to meet some of the many criteria for the state’s insurance programs, we want to engage them and pull them in and try to enroll them in these programs,” Calbone said. “You wouldn’t find that in a typical physician’s office.”
Besides having a patient navigator on hand to help those who may be feeling overwhelmed, the CHRC is also hoping to create offices for several local not-for-profits so patients who might need other resources can find help in the same building.
“The thing we want to do is keep people from getting the runaround,” Lee said. “I found myself heading up this effort and I’ve learned a lot about bureaucracy and red tape, and what drives a lot of people crazy about nonprofits overall is being told to go here for this, or there for that. You just don’t have the energy to fight all those battles, so what we really want is kind of a one-stop shop for health; mentally and physically.”
Calbone emphasized that though a lot of people have confused the new center for a clinic, it is not a clinic and will be run like any other ordinary primary health care office.
“[A clinic] typically implies that you come in and take a number, sit in a waiting room and someone at some point may see you,” Calbone said. “It’s going to be organized and operated as a traditional practice where you’ll be brought in for initial visit appointments.”
Calbone also said that in the long run, opening the center will save the hospital in money and resources.
“It is much more expensive to run an emergency department than it is to run a practice like we’re describing, considering many of the individuals we’re talking about don’t have a payment source,” Calbone said. “We believe that keeping people in the process and assisting them in their relationships with medical care keeps them healthier and prevents catastrophic illnesses and the unmanaged chronic diseases that put them in the ER, so ultimately over time we will spend less on the hospital side.”
Though the CHRC will primarily be targeting the demographic of uninsured or underinsured patients, both Calbone and Lee stressed that the center will be open to anyone and everyone, whether you have insurance or not.
“Everybody in the community is welcome and everyone will be treated the same,” Lee said. “There will be no difference to someone who walks in with a fur coat and someone who walks in with no coat.”
Sitting in the heart of downtown Saratoga on Hamilton Street right by a bus line, the center is in a prime location where patients can walk from their homes or businesses downtown, or ride the bus to and from their homes.
The Saratoga Foundation has raised the majority of the funds needed to operate the Community Health Resource Center, but still has $300,000 to go before they reach their ultimate $3 million goal.
“The last money is always the hardest money to get in,” Lee said. “The good thing is we already have the money to pay the hospital back for the center — what hurts us is [raising money] for the endowment component. The interest from that would offset the losses of the center, which over a year’s time will be around $600,000, so we really want to raise the money for the endowment.”
Though the center was originally set to open this month, the opening has been delayed until June 1 while the center waits for renovation approvals from the Department of Health.
“This thing isn’t going to be fully defined the moment we open it and it’s not going to be finished product on day one,” Calbone added. “I’m convinced that as we go into this we’re going to look at it and say, ‘Whoa, we didn’t see that coming—we didn’t know that was going to be predominant need inside all these other needs,’ so we’re happy to say we don’t have it all figured out. We want to grow and change as we see the demand.”
“I’m really excited and I think Saratoga Hospital is doing a great thing,” Dr. Tumuluri said. “I want it to be a success story and an example of how communities can take care of each other.”
Until then, the Saratoga Foundation will be busy trying to raise the last of the funds needed for the center’s endowment. To make a donation, go to www.saratogahospitalfoundation.org and click on The Capital Campaign for Saratoga Hospital, click Donate Now and then select the Community Health Resource Center Campaign. You can also call the Foundation office at (518) 583-8340.
