Edith Gonzalez sat in the cramped waiting room of the Adams-Morgan Clinic as her 3-year-old son Walter played with several other youngsters. Gonzalez has been bringing him to the clinic since he was born for routine checkups and problems with asthma.
She said that although she sometimes must wait several weeks for an appointment, the clinic is her only alternative to paying a private doctor because of the family's meager earnings.
For Gonzalez and other Hispanics in the District who depend on the Adams-Morgan Clinic for their health care needs, the long wait for appointments may soon be over.
The District is embarking on an ambitious $400,000 program to expand significantly health services to the growing number of Hispanic immigrants moving into the Adams-Morgan and Mount Pleasant areas, health officials said.
The program, dubbed the "Hispanic Initiative" by D.C. Public Health Commissioner Reed V. Tuckson and to be launched in January, calls for spending District dollars for a major expansion of the federally funded, privately run Upper Cardozo Neighborhood Health Center and an aggressive public relations campaign designed to reach Hispanic clients.
The expansion is needed to relieve the overburdened, District-run Adams-Morgan Clinic in the basement of the Marie Reed Learning Center at 2200 Champlain St. NW, which has no room for expansion, D.C. officials said.
The Adams-Morgan Clinic, which last year served 7,000 patients, 90 percent of them Hispanic, often has a long waiting list, officials said.
Arlene Gillespie, director of the D.C. Office of Latino Affairs and one of the primary movers behind the initiative, said the philosophy behind the Cardozo clinic expansion is that the health and social needs of Hispanics would be better met by the increased bilingual staff.
Under the plan, the clinic's 50 health services employes would be augmented by 12 bilingual staff members, including a social worker and outreach coordinator. The services for Hispanic residents also would be moved into unused space at the clinic's brown-brick, three-story building at 3020 14th St. NW.
Major focuses of the expanded health services would be prenatal care, obstetrics, pediatrics and adult medicine. The additional staff members also would include a pediatrician, nurse-midwife, pediatric nurse, pharmacy assistant, nutritionist, dental hygienist, as well as Spanish-speaking clerks and receptionists.
"My philosophy is that there is more to a health problem if you dig into the social conditions," Gillespie said. "And there are certain social conditions, that if they are not taken care of, you might not be able to solve the health problem."
The expansion of the Cardozo clinic would be exclusively funded by the District government, but it is contingent on the clinic receiving its yearly funding from the federal government. The Cardozo clinic is operated by the National Health Plan, a private, nonprofit agency.
The joint effort, which would include expanding the number of Hispanics on Cardozo's board of directors, follows two years of discussions between the District government and Cardozo officials. Tuckson said that if the proposal is accepted by the U.S. Department of Health and Human Services, this would be the first cooperative effort by the District government and a federally funded health facility.
According to D.C. officials, the area served by both clinics -- bounded roughly by Piney Branch Road on the north, S Street on the south, Park Place and First Street on the east and Rock Creek Park on the west -- is 28 percent Hispanic. Out of 93,000 residents in the area, about 26,300 are of Hispanic origin.
The officials say one reason the Cardozo clinic has been underutilized by Hispanics is the small number of Spanish-speaking employes there. At Cardozo, 10 percent of the staff speaks Spanish, compared with 80 percent at the Adams-Morgan Clinic.
More Hispanics also seek health services at the Adams-Morgan Clinic because of the low fees it charges indigent patients compared with the more stringent federal income requirements at Cardozo, some officials said.
The Gonzalez family, from El Salvador, is one of those in need of the low-cost services of the Adams-Morgan Clinic, to which it also looks to solve other family problems. Edith Gonzalez earns $3.35 an hour cleaning a church, and her husband, a carpenter, earns about $200 a week. They live in a rented apartment near Adams-Morgan, where they split the $800 monthly rent with several family members.
Gonzalez said several months ago doctors at the clinic discovered that Walter was suffering from lead poisoning, which she said he contracted by eating lead paint in the family's apartment.
They have since moved out but the landlord refuses to return their $450 deposit, and Gonzalez said she planned that day to ask the doctors at the clinic to write her a letter about the boy's condition. "Maybe when he sees the letter, he'll change his mind," she said.