In April of 2009, a community health care clinic closed in St. Louis, Missouri. La Clinica served the immigrant community of St. Louis, offering multilingual medical and dental care for $20.00 per patient. The clinic was founded in 1995 and was known to provide outstanding care to its clients. It also stood as an example of how medical facilities should incorporate immigrant populations into their health care service provider models. After years of financial problems and struggles to find sources of consistent funding, news came that La Clinica would close. As a result, thousands of immigrants from multiple communities across the city of St. Louis were left without a trusted health care provider. Immigrants face language and financial barriers to accessing health care in St. Louis and across America, and given the lack of alternatives, many dreaded the impact of the loss of this clinic on our newest St. Louisans. News that La Clinica has been reborn as Casa de Salud through a partnership with St. Louis University was met with celebration and relief. But the question remains, what does a partnership with the region’s powerful Catholic University mean for patients of the new clinic and their access to the full range of reproductive health care options?
When local St. Louisans Maxine Clark (founder of Build-a-Bear) and her husband Bob Fox were contacted by staff of La Clinica and alerted that the clinic was closing, they began to work on a plan to secure financial funding for another clinic to serve St. Louis’ growing immigrant population. As former donors to La Clinica, Fox and Clark understood the role the clinic played in St. Louis and wanted to make sure that a new clinic would have the kind of support that would protect it from the ups and downs of the economy. La Clinica had tried to cut costs by using free drug samples from pharmaceutical companies and securing considerable volunteer support from the medical community, but the clinic was ultimately unable to make it work financially. In keeping with the new goal of combining financial stability with low-cost, high-quality multilingual care, supporters partnered with St. Louis University (SLU) and La Clinica has been reborn as Casa de Salud.
On the surface it seems like a miraculous resurrection. St. Louis University is Casa de Salud’s founding and sustaining partner. The St. Louis Business Journal reports that the new clinic, Casa de Salud, is located in a building owned by SLU and the university is leasing the 6,000-square-foot building to the clinic for $1.00 a year. SLU financed the rehab of the facility, is paying the utility bills, and providing security and maintenance. SLU is also providing Casa de Salud with support in human resources, development, legal, marketing and administrative services.
According to their new website, “Casa de Salud (Casa) is a new health and wellness center dedicated to meeting the needs of patients who encounter barriers to accessing other sources of care. With an emphasis on new Hispanic immigrants, Casa provides high quality, respectful, low-cost healthcare along with assistance in navigating the healthcare system.”
Sounds fantastic, but the very source of all this generosity was also an initial cause for concern. St. Louis University is a Catholic, Jesuit University and has a long history of activism against abortion rights. The annual 40 Days for Life protests held their opening rally kick off event at St. Francis Xavier Church on SLU’s campus. So, when I heard that the savior of this clinic was SLU my heart sank. My anxiety was heightened by news of the excommunication of Sister Margaret McBride, the nun who approved an abortion that was necessary to save the life of a woman. I imagined the worst – that the new go-to low-cost, high-quality and multilingual health care provider for St. Louis’ immigrant community would start referring women seeking information about abortion services to crisis pregnancy centers (CPCs).
Here’s the good news – the very change to the clinic’s operating model that will likely keep costs down also has the side benefit of creating a buffer between SLU’s Catholic ideology and clinic patients. Specifically, Casa de Salud’s operating model will not duplicate services already available in the area. The clinic staff will assist patients in connecting with existing providers in the community, which will keep costs down while maintaining access to services. So it seems that this is more a case of reincarnation than resurrection, with Casa de Salud emerging in a new form altogether. When I contacted Casa de Salud about whether they referred patients to health care providers who offer abortion services in the region, I was told that the clinic does not have a policy [on abortion] and decisions like that would depend on the policy of the physician to which the cllnic refers the patient. Looks like the buffer is up and only time will tell whether it will hold.