Roseland Community Hospital is nestled neatly on 111th Street, the far South Side of Chicago serving a population of uninsured, underinsured people, poor people. Servicing Roseland, Pullman, Morgan Park, Greater Roseland, Altgeld, Maple Park and south suburban communities; Roseland practices urban medicine in a health care desert.
The typical hospital patient is African American or Hispanic. The intake is approximately 28,000 per annum. The emergency room is often the first stop for medical services for this community suffering from high unemployment rates to boarded-up homes. Patients wait to be treated for illnesses ranging from a cold and asthma to severe health issues such as strokes, heart disease and gunshot wounds.
Their emergency room, on Fridays, is a war zone due to the paramount of violent victims. The average gunshot wound treatment ranges from $60,000 to $100,000, usually not covered by insurance.
The 162-bed hospital features a new Adolescent Behavioral Health Unit that cares for disturbed youth. It is the only center of its kind south of Roosevelt Road. The center has been open just over a year and has provided care for over 350 teenagers with emotional and/or behavioral issues. The hospital has one of six digital mammogram technology machines to detect breast cancer. The digital technology provides a 360-degree surround view of the breast rather than a one-dimensional view, providing greater detection.
One out of every eight women is subject to acquire breast cancer. This is the most sophisticated technology for mammography of its kind in the Midwest. The technical name for the machinery is Phillips Mico Dose System. There are only six such systems in the country. African American women are more prone to death from this disease than white women. Early detection results in increased quality health care and longer life. Roseland Community Hospital was awarded this advanced digital technology screening equipment from a grant.
The hospital also offers a hyperbaric oxygen therapy. This benefits wound victims, infections and carbon monoxide poisoning. The hospital operates a state of the art emergency facility.
Roseland has received major news coverage lately as it threatened to close due to a lack of funding. Community groups have championed their plight. Reverend Jesse Jackson of Rainbow Coalition and Bishop Tavis Grant, the National Field Director have issued the clarion cry to the politicos include marching, rallies and meeting with principals for all parties concerned. Dr. A. Edward Davis, Jr. of St. John Missionary Baptist Church held a town hall meeting in his church for the community at large to let the people know the scope and reality of the problem. Union leader, Executive Vice President, April Verrett of Service Employee International Union – Health Care Illinois has been on the marching front line with hospital workers.
The issue is to keep the doors open for the sick and poor. Governor Quinn has been pressured. Roseland is Chicago’s most isolated hospital. There is not another in an eight mile radius. Should Roseland close where does a patient go? It is not the forefront of medicine.
In August of 2011, Governor Quinn signed a law designating the Roseland Community Medical District that would help the far south side of Chicago attract high technical research investments. The Medical District Commission will consist of 12 members, with three being appointed by the Governor, the Mayor of the City of Chicago and the President of Cook County. Not all of the appointments have been made to date. Staff from the Illinois Department of Human Services, Illinois Departments of Commerce and Economic Opportunity and Illinois Department of Public will serve as ex-officio members. This legislation generates and attracts economic development with the goal of attracting academic institutions, medical research facility and high tech businesses. Today, the Roseland Community Hospital impact represents $154 million and has employed over 500 people, making it the largest employer in the area.
The Roseland Hospital issue raises a serious question in urban medical health care for safety net hospitals. Chicago’s South Side does not have a trauma center. We are feeling the absence of Michael Reese Hospital. The business of medicine has changed, as have all things. Insurance is an issue. If you are not insured, you are in trouble. Some hospitals will not accept an uninsured patient, no matter how serious the illness. The remedy for this is Cook County Care and Obama care. You do have to register for these services and people are slow to do so. The county care has had poor marketing and outreach. Obama Care still has much confusion, a lot of doubt, and requires clarity for eligibility.
The Roseland community is plagued with youth violence. The gangs often bring the wounded to the doors of Roseland because the hospital policy will not turn away a sick patient, consequently the financial dilemma. The hospital suffers a $25 million annual deficit for “compensated care,” that is, patients unable to pay for services. For every $1.00 spent on medical care, Roseland receives a mere 17 cents. The business model works at a deficit.
The closing is real, but it is not an option
The threat of closing Roseland is real. Dian Powell has been the President and CEO of Roseland Hospital. She inherited a debt of $8 million and reduced it to $4 million in an 18-month period. She stepped down so as not to become the target of blame and to insure the hospital received the necessary funding. The business model needs to change; the state funding needs to increase and the insurance patient needs to grow. With the declaration of Roseland as a Medical District, the Hospital should be on point to thrive and expand rather than suffer.
As the business of hospital has changed, hospitals are becoming specialized facilities. Ailments such as organ transplants, cancer treatment institutions, joint replacements and the like, are the vogue practice of the day in the multimillion medical centers. But what happens when you fall down and break a leg or arm, or if you are in an auto accident or if you happened to get wounded or you have an asthma attack, where do you go? It is more than likely the community hospital.
All hospitals are not equipped for trauma. Trauma centers are expensive units with equipment as well as full service staffing. Northwestern is an excellent trauma center, but they are in the Gold Coast, 15 miles away from Roseland. The University of Chicago Medical Center is almost 9 miles from Roseland. It is on the forefront of medicine but is at capacity and does not necessarily want the trauma patient. There has been public demand from students and community residents of Hyde Park to insist that the University of Chicago become a level one-trauma center. The Chicago area has a total of seven Level 1 adult trauma centers. The situation begs for legislation providing for community hospitals and/or a law to guarantee a trauma center to a demographic by population or area destination.
South Side citizens and South Suburban citizens needs to pay attention to the Roseland case, because if you just happened to be driving on the Bishop Ford Highway or the far south side of the Dan Ryan and an accident occurs, Roseland might be your destination hospital.
Emergency room doctors point out that in the instant of an emergency, money does not matter, minutes do. The small community hospital is an important place in the community. It provides a sense of well being.
In a recent study conducted by Dr. Marie Crandall, a professor of surgery/trauma care at Northwestern University, revealed that over a 10-year period (1999-2009) after analyzing 11,744 gunshot patients, that patients were disproportionately black and less likely to be insured. The study reports, “We have identified the southeast side of the city as a relative trauma desert in Chicago’s regional trauma system that is associated with gun shot wound mortality.” The study suggests that if one is shot and not within five miles of a hospital, the mortality rate is likely to increase. In other words, the further away you are from a trauma center the higher the mortality rate.
As of this writing, Governor Quinn provided emergency rescue funding for Roseland Hospital with a $350,000 payment, allowing another two-week payroll. It is a financial band-aid on a cancerous situation. The State is examining the finances of Roseland to see what might sustain the institution. There is a possibility that some type of affiliation might come about with West Side hospital, Loretto. But is this a long-term medical solution, or is it a quick political fix?
With all good faith effort, Roseland needs to remain open and with the spotlight on the community now it needs to be judged on the fundamental conditions and resources for health which include: peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice and equity.