Health center expands beyond HIV-AIDS role

Success: A Mount Vernon health center's patient load has grown to the point that it is hiring more people and buying the building next door.

April 01, 2002|By M. William Salganik | M. William Salganik,SUN STAFF

The change in mission came before the change in marketing.

For about two decades, Chase Brexton Health Services was a health center in the Mount Vernon area of Baltimore, focused primarily on HIV and AIDS.

Chase Brexton Health Services began as a small health program in Baltimore's Gay and Lesbian Community Center. Early in its history, however, it became independent and focused on HIV and AIDS, drawing substantial numbers of nongay HIV patients to its health center in the Mount Vernon area of Baltimore.

Over the past five years, it has added a suburban location and evolved back toward its roots, returning to an emphasis on the gay and lesbian community. It offers primary care and a range of other health services, while continuing to treat patients with human immunodeficiency virus and acquired immune deficiency syndrome.

"We've hung a different shingle," with an effort to "position us in a different light, and tell gays and lesbians that this place is not just about HIV," said David H. Shippee, Chase Brexton's executive director.

The change in direction, Shippee said, reflects both patient demand and economic realities.

On the patient side, he said, relatives and partners of HIV patients were seeking general, non-HIV medical care as well. Chase Brexton's board and management thought, according to Shippee, "We have the infrastructure, we have the passion; we just don't have the services to offer."

By 1996, Chase Brexton began adding doctors and moving toward becoming more of a full-service health center.

The change dovetailed with Chase Brexton's concern over having stable revenue. Many of the HIV patients were not gay -- and not insured. When Shippee arrived a decade ago, 85 percent of the center's money came from grants, mostly from the federal government.

Chase Brexton has been financially stable -- it's been in the black for the past eight years. However, it feared that government grants could shrink if there were a change in the political climate, so it was looking at "sustaining the organization with other streams of revenue."

The new services allowed the center to attract more insured patients through commercial health plans or Medicare and Medicaid coverage. Currently, about a third of Chase Brexton's patients are uninsured, nearly half have Medicare or Medicaid, and the rest are commercially insured.

Now, Chase Brexton gets about 60 percent of its revenue from clinical services and only 28 percent from government grants, Shippee said. The remainder of the $19 million annual budget comes from corporate and individual donations.

Three years ago, Chase Brexton added a Pikesville location, chosen for its Beltway access for suburban patients. "Not everybody that's gay in this town lives in Bolton Hill or Mount Vernon," Shippee said.

From the beginning, the Pikesville office offered general health services, not just AIDS-HIV care, and, in Shippee's words, "a private practice touch."

Having changed its service mix, Chase Brexton decided it needed a marketing approach to "telling insured gays and lesbians that this place is not just about HIV."

However, he said, "We equivocated on how boldly we could do that," over concerns about offending funding sources and "how to keep patients comfortable if they're not gay or lesbian."

Chase Brexton hired MGH Public Relations of Owings Mills. After discussing various approaches, said Michael O'Brien, executive vice president of MGH, Chase Brexton "arrived at, `This is who we are, proudly.' "

A complication, O'Brien continued, came in the lack of market research data. Eventually, MGH conducted focus groups to help Chase Brexton shape its message.

Chase Brexton began advertising in the City Paper and the Baltimore Gay Paper, describing itself as "Baltimore's premier gay and lesbian health provider," with the headline, "We want everyone to know."

Other centers with similar missions have also wrestled with how to market themselves, said Angela Wilcox, communications manager for Fenway Community Health Center in Boston. A brochure says, "We treat people like the individuals that they are -- gay, lesbian, bisexual, transgender, and straight."

Chase Brexton's patient load has been growing. The health center now has 117 staff members serving 1,400 HIV patients and 4,000 other patients.

With a months-long waiting list for some services, it's buying the building next door to its Cathedral Street center and expects to add 17 more staff.

It's also engaged in a capital campaign, and has raised $1.3 million toward its $2.5 million goal.

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