ASOs strive to see more clients more quickly but, Parkland patients continue to wait months
Raeline Nobles
DAVID TAFFET | Staff Writer
taffet@dallasvoice.com
Over the past year, the wait time to get an appointment at Parkland hospital’s Amelia Court appears to have gotten longer, although the staffing level appears to be about the same now as a year ago.
During that same time, community-based AIDS agencies in Dallas say they have expanded services and decreased wait times.
For new Parkland patients, the time from first contact to seeing a doctor can be as short as two weeks. But new patients trying to access services at the public clinic recently have reported waits of as long as four months.
Candace White, Parkland media spokeswoman, said that the clinic is taking new patient appointments as early as February and through March 1. She said she confirmed that with Sylvia Moreno, the hospital’s director of HIV services.
White attributed the delay to an increase in the number of patients accessing the clinic’s services due to successful HIV testing efforts throughout Dallas County. Some of the longer wait times quoted over the past few weeks may have been due to the holiday, she said.
However, when a Dallas Voice staff member called Amelia Court on Tuesday, Jan. 10, to make an appointment, he was transferred to voicemail to leave a message. As of deadline time on Thursday, Jan. 12, more than two days later, no one from the clinic had returned the call.
Another caller to Amelia Court was told that those February and March appointments White cited are reserved for established patients only. The next available appointment for first intake for new clients who want access to Amelia Court is April 23, the caller was told.
The Ryan White CARE Act, which funds many of the treatment programs for persons with HIV, specifies patients must receive “access to care within three weeks of presenting,” Dr. Gary Sinclair, former medical director of Amelia Court, said.
While he was at Amelia Court, Sinclair said that he and his staff reduced the waiting time to access medical care to two weeks. He left UT Southwestern and Parkland two years ago and is now an independent consultant involved in covering for physicians for Ryan White programs.
For years, all Parkland primary AIDS care was done at Amelia Court, located on Harry Hines Boulevard, a block from the main hospital. However, to relieve overcrowding at Amelia Court, doctors with experience in treating people with the virus have been seeing patients at three of the hospital’s Community Oriented Primary Care facilities in Dallas.
Parkland began opening the COPCs in 1987 to relieve its main emergency room of treating non-emergency cases.
The clinics were designed to provide convenient and affordable healthcare throughout Dallas County.
HIGH RISE CLINIC | Amelia Court’s HIV services will move to the new Parkland Hospital under construction across Harry Hines Boulevard from the old facility. (DavidTaffet/Dallas Voice)
Some of the facilities also have specialties. Two clinics — Bluitt-Flowers Health Center in South Dallas and Southeast Dallas Health Center in Pleasant Grove — were designated as HIV treatment sites.
A third — deHaro-Saldivar Health Center in Oak Cliff — previously treated adolescents and young adults with HIV, but that service has been discontinued.
Parkland’s clinic has been staffed at about the same level for the past several years.
But as HIV has changed to a manageable chronic illness, Sinclair said that there has been “a normalization of care.”
That normalization may include longer waiting times for appointments at the public hospital, something that is common in other specializations.
But while Parkland strives to keep the wait time for primary care down, some local agencies that provide clinical service to people with HIV at low or no cost say they have expanded their service and will see new patients quickly.
“On a very human level, it can be quite terrifying to want and need medical care and not be able to find it,” AIDS Arms Executive Director Raeline Nobles said. “AIDS Arms built its second HIV clinic to help with these exact problems in significant and positive ways.”
The agency opened Trinity Health & Wellness Clinic in Oak Cliff this past fall and continues operating Peabody Health Center in South Dallas. Both offer full primary care for people with HIV.
AIDS Arms accepts Medicare and Medicaid as well as private health insurance. And like the county hospital, medical care is free for low-income people without any coverage and is provided on a sliding-scale for others.
Intake takes about a week to complete, Nobles said. Once a person who has an HIV-positive diagnosis is registered as a client, doctors at Trinity Clinic can see a new patient that week.
“With fast access to medical appointments at our Trinity and Peabody clinics and five licensed providers, we are a partner in the solution to very large and disturbing access to care problems in our community,” Nobles said.
The agency is seeking to expand the services it offers its patients and is currently looking for specialists in ophthalmology, cardiology and renal care to supplement its care.
In addition, AIDS Arms is involved in drug research trials, something Amelia Court no longer does.
Sinclair said he believed that was part of a shift in federal research dollars away from “’How do we treat people?’ to ‘How do we eliminate the epidemic?’”
In addition, AIDS Arms is offering several new services to its patients at its Trinity clinic.
Legal Hospice of Texas will soon begin providing on-site legal assistance for disability, social security and HIV-related discrimination issues. Bryan’s House will be providing free childcare for patients visiting the clinic on Thursday and Fridays beginning next week. And once a week, onsite psychotherapy services will be offered.
Resource Center Dallas offers a variety of specialized medical services at its Nelson-Tebedo Community Clinic on Cedar Springs Road. Dental care is the most frequently accessed and something not provided by other agencies or Parkland.
With a recent expansion of facilities at the clinic, RCD Communications and Advocacy Manager Rafael McDonnell said the wait time for an appointment is three weeks or less. He said the clinic is able to treat emergencies even more quickly.
This article appeared in the Dallas Voice print edition January 13, 2012.
It’s Parkland. What do you expect? If they take about 19 hours to even see patients with life-threatening emergent medical conditions from the time they come to the waiting room (such as case of the late Mike Herrera who died of a heart attack while in the waiting room in the ER), then why not expect to wait 4 month, or not get a call back at all, for HIV treatment. All problems at Parkland are due to one thing—that being they are only public hospital for the entire county, and therein lie all the problems with Parkland.
They are the only game in town in terms of public health and have completely lost touch with having to do a reasonable job in satisfying their patients’ needs.
Parkland has gotten so big and bloated over the years, with no competition, that they’ve forgotten how not to take their patients for granted. If you anger most of them, what are they going to do, and where are they going to go? All the problems that Parkland and UTSW have encountered, thus far, stem from the fact that there are no alternatives for their patients. Thus, Parkland has gotten arrogant and complacent about even maintaining the minimal standards of care that are no-brainers to any other hospital.
Parkland has become too big for its own good, thus they have lost touch with who they are and what their mission is supposed to be in how to run a hospital in a safe, efficient, and honest manner.
This latest incident shows me that Parkland has not learned its lesson. That’s probably why they lost their Medicare/Medicaid status, and why UTSW and Parkland have lost two federal lawsuits already to two different whistleblowers for patient billing (Medicare/Medicaid) fraud and racial discrimination (against Dr. Beth Levine, Chief of Service at Amelia Court.) So sad.
F. Anderson – I couldn’t agree with you more. The last time I went to Amelia Court the scales didn’t even work properly, which was an issue because I had lost too much weight. The doctor took me to another scale, while laughing about the malfunctioning on in the triage area. To make matters worse, places like Nelson Tebedo don’t seem to understand the difficulties of receiving care at Parkland. They are hounding me to provide them with lab results, when they have my most recent lab results from October. I told them that my next blood draw and labs are schedule for Jan 18th and it can take up to 10 weeks to get an appointment with my doctor. Seriously!!! 10 weeks. The problem is made much worse by drug addicts using the resource center services and not receiving any medical care whatsoever.