Columbia Road Health Services
Allen Goetcheus, President
Janelle Goetcheus M.D., Medical Director
Hetty Irmer, Development Director <== interviewed
1660 Columbia Road NW
Washington, D.C. 20009
(202) 328-3717

Back in 1979, when Allen and Janelle Goetcheus were planning to go to Southeast Asia as missionaries, they visited Washington to get visas. While they were there, they got a glimpse of the city's poverty through the non-denominational, service-oriented Church of the Savior; and stunned by the shame of poor people with no access to health care in the heart of the nation's capital, they changed their plans. By 1975, they had opened a small health clinic in a two-bedroom apartment on Columbia Road, and soon afterward founded Christ House, a medical center for homeless men.

Two decades later, the clinic -- now moved into more spacious quarters in a storefront that used to be a butcher shop -- has case files on 5,000 patients, served by a staff of 24 supported by a $1 million budget.

Reflecting the changing community, its clientele, once predominantly African-American, is now 80 percent Latino, and the clinic has responded by ensuring that all its medical assistants are bilingual. One-third of the patients are children, and most of the adults are women. One-third of its budget comes from patient payments and insurance; the rest is from individual donations and foundation support. It receives no federal funding except Medicaid reimbursements.

While six of the clinic's medical staff work on a pay basis (most of them part time, the six totaling just over two full-time equivalents), their work is bolstered by volunteers. Patients needing specialty care are referred to specialists through an innovative local initiative, the Archdiocesan Health Care Network, a clearinghouse for medical practitioners in many specialties who will offer free or low-cost consultation to low-income patients.

Although the clinic is not free -- patients pay for services on a sliding scale based on income -- it makes a concentrated effort to serve the neediest patients in its community, and no one is turned away because of inability to pay.

In a key, innovative feature, the clinic takes a "holistic" approach to health care, treating not merely transient symptoms but the entire patient. Full-time social workers interview every new patient and open a case file as part of the health-care process, examining not only the immediate ailment but other issues in the patient's life that might influence health and wellness. The clinic also offers 12 Step addictions counseling, and through Allen Goetcheus, who is an ordained Methodist minister, non-denominational pastoral counseling.

All the feature stories on @GRASS-ROOTS.ORG's pages are reported and written by Robin Garr, a prize-winning journalist who has visited more than 500 innovative grassroots programs in all 50 states since 1990.

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