Already On The Front Lines Of Health Inequity, Free Clinic Embarks On 18-Month Review

The Community Health Care Clinic in Normal will use a $30,000 grant from the Institute for Healthcare Improvement to participate in the IHI’s Pursuing Equity Initiative.

During the 18-month review, the clinic will examine its current practices and further develop policies and procedures as it strives for health equity.

“The timing was perfect because it’s right along with everything surrounding what happened with George Floyd and all the racial tensions,” said Mike Romagnoli, executive director of the clinic. “Every outlet was putting out a statement on the racism, but they didn’t have the ‘and here’s what we are going to do about it’ part, and we were waiting until we could put in our ‘and here’s what we are going to do about it.’”

After being chosen for the Pursuing Equity Initiative scholarship, the clinic had its moment.

The clinic’s staff and board will go through the program, looking at how to better align the clinic with the IHI’s Pursuing Equity five-component framework. That includes eliminating racism and other forms of oppression, and partnering with the community to improve health equity.

Romagnoli said the need is evident in the fact that 86% of the patients seen at Normal’s free clinic, which was founded 27 years ago, are non-white. The majority of the patients served at the clinic are service workers and others who are not eligible to receive health insurance.

“Service workers are absolutely the foundation of the Bloomington-Normal economy, but are traditionally not insured,” said Romagnoli.

The Pursuing Equity Initiative calls for building out the infrastructure needed to support health equity. One way that plays out at the clinic is being able to serve non-English speakers.

It’s already built that infrastructure for Spanish-speakers. About 70% of patients speak Spanish, and the clinic has five bilingual members on staff. The clinic even sends these staff members with the patients to specialty appointments, so they can comfort and fully communicate the information being provided.

“We are well known as a safe place for the Spanish-speaking population,” said Romagnoli. “If one of my staff goes to those appointments two things happen: The patient has a familiar face with them in a strange office, and we know … what happens.” 

Less well served, Romagnoli conceded, is the increasing number of patients from French-speaking African counties, primarily Congo. Recently, the clinic had an Illinois State University professor and two students assisting with translation, but more will be needed.

“It is amazing with proper translation how much more information we’re getting from our French-speaking patients,” said Romagnoli.

Health inequity also is evident in the high rate of asthma in west Bloomington, he said.

“Asthma is one of those things that with proper medical care is very treatable, but the medications for it are super expensive,” said Romagnoli. “You can go to the ER when you have a flare-up, you leave feeling better, but you’re going to leave with a handful of prescriptions that you cannot afford.”

Moving forward, the clinic also hopes to see more diversity on its board to have a better representation of the Bloomington-Normal population.

“If my board was a reflection of our clinic population, it would look a lot different,” said Romagnoli, noting that is a challenge for many organizations in Bloomington-Normal.

Clinic leaders say they hope the Pursuing Equity Initiative leads “to not only an organizational but a communitywide transformation in the way we address the issues that disproportionately affect people of color.”