News & Media

AURORA’S IMMIGRANTS: New lives, new healthy starts

Health Care Reform

January 31, 2014  |  The Aurora Sentinel  |  Link to article

AURORA | The lobby of the Colorado Refugee Wellness Center in north Aurora is lined with brochures. One in Arabic gives tip for stress management; another in Nepalese describes proper dental care.

“Five or six years ago, the majority of refugees got resettled in Denver. Now, the majority are being resettled in Aurora,” said Dr. Jamaluddin Moloo, who serves as the center’s medical director.

Simultaneously, the Anschutz Medical Campus, where a majority of the city’s multinational population is located has grown to be one of the largest academic health centers west of Chicago.

Providing services that reach people who may not otherwise have access to medical care has been an increasing focus of the University of Colorado hospital in recent years.

Moloo, an associate professor in the CU School of Medicine who practices at University of Colorado Hospital, said the center receives most of the 2,500 refugees that are resettled in Colorado each year. The program provides screenings for new refugees in partnership with Colorado Department of Public Health and Environment, and it also serves as a primary care clinic for refugees.

Moloo said the center provides a unique experience for residents training at University of Colorado Hospital.

“We structure their rotation so when they come, they do a lot of outreach,” he said.

“They literally go and pick up a refugee family when they first land at Denver International Airport, take them to their new home. They spend a good bit of time with our community-based organizations that do outreach and home visits.”

The training, Moloo said, is a way to help open the eyes of future doctors to the hardships refugee patients face once in the United States.

“What you learn about a family seeing them in a clinic is night-and-day (different) relative to the discussion you have with them when you go to their home. It’s harder to hand them a prescription and say, ‘Take this, and you’re going to be better,’” he said.

A 2013 University of Colorado Hospital study of community health care needs mandated by the Affordable Care Act, showed health access as the top issue for residents in Arapahoe, Adams and Douglas counties.

Bridges to Care, a federally funded pilot program based in four U.S. cities, follows an initiative developed in New Jersey to identify “hotspotters,” or people who overuse emergency room care. The Aurora program, which began enrolling patients in January 2013, was created to serve area residents who frequently visited the UCH emergency room as a result of not having access to appropriate care.

According to Metro Care Provider Network, a partner in the program and the only safety-net clinic for patients in Aurora, from July 2010 through June 2011, residents of Aurora zip codes 80010 and 80011 accounted for 30,694 ER visits to UCH.

Sophia Alires, a clinical care coordination manager with MCPN, said the program is about educating patients, not just enabling them. “It’s to give them resources to become successful after 60 days,” she said.

In the program, patients receive at least eight visits to their home from health workers at Aurora Mental Health and MCPN. They’re encouraged to share their stories and give their opinions through volunteers at Together Colorado and Aurora Health Access. MCPN also works closely with patients to link them to an MCPN clinic for ongoing primary care after they leave the program.

As of publication date, Metro Care Provider Network has enrolled 305 patients in the program with a goal of enrolling 900 by 2015.

So far, over 30 percent of the patients have graduated from Bridges to Care, and some saw hundreds of thousands of dollars in cost-savings on their medical bills, according to data from MCPN.

Dr. Gregory Misky, who works in Internal Medicine for UCH and serves as a liaison between the Bridges to Care program and the hospital, said before the program started it was difficult to even keep track of hotspotters — let alone formally help them.

“We’ve created a system within our electronic record that’s now better at tagging patients on what their payer source is, and whether they have a medical home,” he said.

UCH has provided $329 million in net charity care for 2013, a 14 percent increase from 2012.

The Bridges to Care Program has recently expanded to identify high users of the UCH emergency room in all parts of Aurora.

Misky said the city needs more programs like Bridges to Care.

“Once the grant ends, it’s going to go back to the way it was,” he said.

Misky said he is working with other health care providers at UCH to try to propose a patient navigation program for the hospital’s entire emergency department.

“Some folks come in and need Medicaid enrollment, some have behavioral health needs, some need social structure,” he said.