Mingchu Pearl Huynh had nowhere else to go.
After moving to Philadelphia from New York in 2012, Huynh was without a job and without health insurance. He couldn't afford medical care anywhere, until he learned about the city's health centers, which provide health care at little to no cost to community members in need.
When Huynh, who is the founder of the Northeast Philadelphia Chinese Association, learned that the city had proposed two new health centers in the lower Northeast, she was excited. Currently, there is only one city-run health center in the area. For her, these health centers would be a beacon in a region that lacks access to health care and where there has been a growing concentration of immigrants and lower-income people.
Many agree that health centers are needed in the area. Some don't.
The city's health department announced last year that it plans to build two new health centers, one at the current Friends Hospital on Roosevelt Avenue and the other near the Frankford Transportation Center, in response to city fair that the area's neighborhoods have fewer primary care providers and higher rates of uninsured. Since then, many people have voiced their opinions on the center's proposals through community meetings, letter-writing campaigns and petitions (the latest petition in favor of the health centers received nearly 1,200 signatures).
“There's a real need and these people are underserved,” Huynh said.
The need
Soon after becoming a patient, Huynh became a Chinese interpreter at the Health Center, located just off Cottman Ave.
For four years, he watched immigrants and the newly unemployed look elsewhere for health care because the health center's waiting lists were closed for about six months. And last year, when she joined the advisory board for Health Center 10, she discovered those waiting lists had grown to at least a year for adults.
“I talked to some of my community members and some of them couldn't even make an appointment because there's no room in the [waitlist],” said Huynh, who has often referred young immigrants to their nearest health centers.
The current wait time for Health Center 10 is about 10 months, according to the city, and the average wait time at the remaining eight health centers is four months for young adult patients and 24 days for children.
The first city-run health center, Health Center 5, was established in North Philadelphia in 1969. Since then, the number of health centers has grown and expanded to various neighborhoods in North, South, and West Philadelphia. While the health centers are revenue-generating and self-sustaining, they receive city, state and federal funding and operate on a total annual budget of $58.8 million.
Regular doctor appointments are critical to treating health conditions and preventing chronic disease. But primary care is often unaffordable or unaffordable for people without insurance and those who are underinsured and therefore still struggle to pay their health care bills. But with their sliding scale structure, the city's health centers accept patients regardless of insurance status, ability to pay or immigration status — allowing them to fill health care gaps across the city.
These gaps are particularly stark in Northeast Philadelphia, where poverty rates have been rising exponentially in recent decades.
According to recent census data, the median household income in ZIP codes surrounding the proposed sites ranges from $39,000 to $57,000, and the share of those without health care coverage is as high as 15 percent in some areas. The city's report, which was done in collaboration with the University of Pennsylvania's Leonard Davis Institute, found that the Lower Northeast is the area of the city with some of the highest numbers of uninsured patients and the greatest need for primary health care.
Lower Northeast is also home to one of the highest concentrations of immigrants in Philadelphia — especially important when considering health center locations because immigrants can't qualify for government-sponsored Medicaid health coverage for five years after getting a green card . Until then, many cannot afford private insurance and rely on Health Center 10 for care.
The health center's uninsured patients pay on a sliding scale that typically costs about $5 to $20 per visit. Health centers also offer dental care, pediatric primary care, women's health care, vaccinations and tests for sexually transmitted diseases, tuberculosis and other conditions. There is also a pharmacy on site. The idea is to provide patients with a one-stop shop for their primary care needs.
“There are a lot of reasons why the health department found this particular site — a lot of analysis went into it,” said Carol Rogers, a health department retiree who currently sits on the Board of Directors of the Philadelphia City Health Center. “If you look at all the health centers in the city, there's only one in Northeast Philadelphia. It's a barren landscape of health centers.”
Filling the void
In response to pressure on Health Center 10 and the need for more health care in the lower Northeast, the Philadelphia Department of Public Health last year announced a proposal to build two new health centers in the neighborhood.
The proposal includes a smaller site, near the Frankford Transportation Center, which will serve approximately 5,000 people annually. The site was not challenged by community members.
A much larger site, designed for 30,000 patients a year, is proposed for space on Roosevelt Avenue in front of historic Friends Hospital.
Both sites are within the 19124 zip code, which the health department has identified as the zip code where most of Health Center 10's patients live, said Council member Quetcy Lozada, and were chosen after a thorough evaluation of more than 40 of possible locations for the health centers.
But since the announcement of the new centers, discussions have begun among community members, particularly about the location of Friends Hospital.
Discussions surrounding the proposed health centers have become so intense that Lozada, who represents the district where the centers will be located, began a series of community meetings in December to provide information about the health centers and hear the views of members. community. Lozada's office has hosted four listening sessions in different neighborhoods and has one more planned.
“There really isn't much for our own community other than the big hospitals.”
“Community voice has always been important and a priority for me,” Lozada said. “I want people to feel that … we're making decisions based on what the wider group of people want.”
Miguel Concepcion, whose “backyard is the tower at Friends Hospital,” knows firsthand how much of a health care desert the area really is and how much of a game-changing center it would be for people without insurance.
“There really isn't much for our own community other than the big hospitals,” Concepcion said. “Bringing these services to a community that has traditionally had to travel miles just to get them [health care] — and the fact that it's very accessible to the community — is very welcome.”
Additionally, with the area's growing non-English speaking communities, having a health center that provides strong translation services will help eliminate the language barriers that immigrants often face when accessing health care, Concepcion said. As many as 43% of surrounding zip codes speak a language other than English at home, according to census data.
The opposition
Despite the demonstrated need and projected benefits of having a neighborhood health center, however, some oppose the project, primarily with historic preservation concerns.
Debbie Klak, a member of the Historical Society of Frankford, has lived in the same neighborhood as Friends Hospital since 1987. For Klak, her main concern with the proposed project is the preservation of Native American relics that may be in the reasons. The current investigation, Klak said, found that a Native American encampment, previously thought to be near Frankford Creek, was actually likely located directly behind Friends Hospital to avoid flooding.
“It's very sacred … that there's a good chance an Indian will camp there,” Clack said. “There will have to be an archaeological survey and dig before anything is built on this ground.”
Many have also pointed to plans to demolish a 170-year-old building on Lawnside on the Friends Hospital campus to make way for the health center, which was approved by the Historical Commission last year.
“If [the health center] it should be placed here … the city should consider it its responsibility not to tear down this historic building, but to incorporate it into its design,” said Oscar Beisert, a historic preservationist in Philadelphia.
Architects working with the health department have identified that the condition of the Lawnside building's structure would make it impossible to incorporate into the project, Lozada said.
“I appreciate historic sites … that help us tell the story of our city,” Lozada said. “But we also have to remember that there are spaces in our city that we as a city have not taken care of and preserved.”
The opposition felt like a slap in the face to those who believe the health center is necessary, and many suspect it's just a “not in my backyard” feeling.
“There will have to be an archaeological survey and dig before anything is built on this ground.”
“I support the preservation of historic sites,” said Izzy Colón, a community policy analyst who was former mayor Michael Nutter's director of multicultural affairs. “But I can't do it at the expense of a health crisis. This, for me, requires a moral judgment.”
Of particular concern to community members in support of the health center is the possibility of finding a new site. While there's no current timeline for when land will be broken for the health centers, the process of finding a new site to replace the Friends Hospital site, Lozada said, will take five to eight years — “time we don't have.” she added.
