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Opening the Doors to LGBTQ-Focused Care

HELPs staff has grown in the last 30 years from just a handful of dedicated individuals to around 30 people, who will provide culturally-competent care to LGBTQ patients.

A clinical dietitian at the Corktown Health Center provides medical nutrition therapy for a patient.

The new Corktown Health Center opening this summer near downtown Detroit will bring LGBTQ health to the forefront. While Southeast Michigan boasts a number of top-notch health systems and individual providers, up until now, there has been no center for LGBTQ health excellence. Patients often feel invisible, isolated or even judged in health care settings.
"The need for quality, affirming care, not just non-discriminatory care, is vital," said Teresa Roscoe, executive director of HELP, the non-profit community-based organization establishing Corktown Health.
"While LGBTQ individuals and families have many of the same basic health needs as their non-LGBTQ counterparts, there are significant health disparities that negatively impact members of the community in different ways."
HELP has been around since 1986 to provide support services and address barriers to care for low income individuals, and for people who are at risk, infected or affected by HIV/AIDS. With greater understanding of HIV transmission, disease processes and the myriad of treatment advances since the 80s, HELP's programs have evolved to address HIV as a chronic illness.
Most people living with the virus today can have long, full lives with effective treatment. In recent years, Roscoe said, they began addressing broader health issues including mental health services and Hepatitis C, which led to development of the center. The next step toward implementing LGBTQ-focused care was to upgrade and expand HELP's facility on Howard Street in Detroit into a 24,000-square-foot complex with a new pharmacy, and community meeting, education and training spaces. Similar models exist such as Fenway in Boston and Howard Brown in Chicago, but this is the first of its kind in Michigan.
HELP initially built out three exam rooms and collaborated with St. John Hospital to provide HIV medical care at the site three days per week. Six more exam rooms are being added as part of the expansion according to Anthony Williams, HELP's chairman of the board. He estimates the center will see 3,500 new patients which equals 10,000 visits a year within the first two years. He anticipates steady growth over the next several years and is focused on ensuring the center is well prepared to manage that growth.

Inside the Corktown Health Center in Detroit will be a total of nine exam rooms where an estimated 3,500 new patients will be seen within the first two years.

HELP's staff has grown in the last 30 years from just a handful of dedicated individuals to around 30 people. They now assist more than 1,600 individuals and families living in Southeast Michigan each year with behavioral health, food and nutrition services, housing and emergency financial assistance, case management, insurance navigation and a range of other services.
The organization's newest efforts were steered by a community assessment conducted in the fall of 2015 through spring of 2016. Williams notes the importance of engaging stakeholders in forming the center's vision. Through a series of four community sessions, they defined core values of inclusion, affirming patients for who they are and accountability. The assessment found that even more prevalent than blatant discrimination was the experience of provider discomfort, insensitivity, lack of knowledge and unconscious bias.
In many ways, providing culturally-competent care to LGBTQ patients should not differ from providing patient-centered care to any other group, according to The National LGBT Health Education Center. As with all patient populations, effectively serving LGBTQ patients requires clinicians to understand the cultural context of their patients' lives, modify practice policies and environments to be inclusive, take detailed and non-judgmental histories, educate themselves about the health issues of importance to their patients, and reflect upon personal attitudes that might prevent them from providing the kind of affirmative care that LGBTQ people need.
Roscoe identified the center's initial priorities as primary care, integrated behavioral health, transgender care, PrEP and care for LGBTQ elders. Assistance with insurance and support services will be expanded to reduce barriers and promote positive health outcomes. "We feel many people urgently need these support services which are integral to the center's holistic approach," she said.
This higher quality of care will be possible with a self-supporting model. "Our objective is to cover 60 percent of expenses through revenue from operations, and the remaining 40 percent through a combination of grants and private contributions," said Williams, adding that this is "an ideal structure because it will allow us to make program and service decisions that are responsive to the community's needs." HELP has already contributed over $300,000 in cash, and garnered nearly $200,000 in in-kind donations to support the build out. They are working towards purchasing the building and will launch a capital campaign next month, according to new Chief Development Officer, Patrick Yankee. He is excited to share more details with a new website coming in May and at their upcoming fundraiser, "Cheers to HELP," scheduled for May 12.
Yankee said, "It will be a fun evening with wine, food, music and an opportunity to support this innovative health center."

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