Since 2006, the Malta House of Care’s mobile clinic has been the primary source of free medical care for a large segment of the uninsured lower-income adults in the Hartford area.
Each week, Malta’s 40-foot-long white van visits four neighborhoods – three in Hartford and one in East Hartford – on a regular schedule at sites adjacent to Catholic churches.
During these stops, Malta’s clinical team – a small paid staff plus volunteer doctors, nurses, and other medical professionals – treats a steady stream of patients who are mostly immigrants and people of color, said Michelle Murphy, Malta’s executive director. About 55 percent are Hispanic, she said.
And while the clinic’s plan of action has adapted to the limitations on personal contact imposed by the COVID-19 pandemic, the charitable organization’s commitment to helping those who might otherwise have little or no access to professional healthcare has not wavered.
Malta House of Care is an independent agency that was created by a group of local professionals who all were members of the Knights and Dames of Malta, a Catholic organization, and were inspired by the Order’s mission to serve the sick and poor.
In 2019, Malta House of Care’s walk-in clinic treated 1,800 unique patients “with compassion and respect” and handled 6,317 patient visits, the most in its history. It also was a record year for donations, Murphy said, with philanthropic grants and donations underwriting the clinic’s $1.4 million annual budget.
Early in 2020, it appeared that the clinic’s rising trajectory would continue. But by March the COVID-19 outbreak had hit Connecticut hard and Malta House of Care reached a major pivotal point.
Malta had to find a way to meet its charitable calling, but without placing staff as well as patients, their families, and communities under greater risk of contagion by the aggressive coronavirus.
“We take seriously our responsibility to reinforce directives from state and federal officials that the best way for people to stay healthy is to stay home,” Murphy said.
The solution that the Hartford-based organization devised was to shut down its mobile clinic and to re-tether its health lifeline to a telemedicine system.
Starting April 6, patients could contact by phone health care staff, many of whom are bilingual, stationed at Malta’s Woodland Street offices, to ask about flu-like symptoms, medication refills, test results, diabetic concerns, and urgent medical issues. The providers would assess the patient’s needs and proceed with appropriate and safe treatment.
On rare occasions, people were allowed to arrange in-person visits, Murphy said. “The patient’s need would determine who (which clinician) was there,” she added.
During the telemedicine setup’s first month, Malta handled 370 patients as compared to a pre-COVID average of 500. However, Murphy said, this turnout “was surprising in a good way, because Malta was uncertain whether many people would know where to find the free health service.”
Five weeks later, Malta was able to resurrect its mobile clinics, at first on a slightly reduced schedule, but with strict protocols based on advisories from the Centers of Disease Control. “As the CDC advisories change, so do our practices,” Murphy said.
“We space patients, usually inside the church, and ask some to wait in their cars; it depends on the weather,” Murphy said, noting that the same distancing is required of staff.
The clinic also conducts COVID-19 screening and referrals to Saint Francis Hospital for free testing. Patients must wear masks; those with flu-like symptoms or other questions should first call Malta’s office at 860-725-0171.
In addition to basic exams and tests, Malta clinicians provide referrals for mammograms, PSA screening for prostate cancer, bone density tests, routine x-rays, and blood work.
The Malta staff also prescribes medications for those who qualify, as well as offering health coaching and education.
Malta House of Care does not cover visits for specialty clinics, ER visits, hospitalizations, tests or surgery ordered by specialists or other doctors, DOT and immigration physicals as well as payments for medications unless approved.
However, Malta is able to provide some non-clinic services at reduced cost thanks to beneficial relationships. St. Francis Hospital donates radiology services for free or at a favorable rate, and Hartford Health Care donates free mammograms, up to 16 a month, and if cancer is shown, the patient is taken to Hartford Hospital for care.
Many of the clinic’s patients come from Hartford area’s estimated 25,000 undocumented immigrants. “We don’t ask immigration status, but could sense many were undocumented,” Murphy said.
The level of trust, as well as the quality of care, among its diverse clientele – from 63 countries these patients, is reinforced by cultural awareness and the ability of several clinicians, including all the medical assistants, to communicate in Spanish. There also are staff members who know Portuguese, which is an asset with Hartford’s Brazilian population increasing, Murphy said.
Malta also does not ask patients about their income. The only requirements are that a patient must be over the age of 18, uninsured and present photo identification, which does not have to be from the U.S. government, Murphy said, adding, “We just want to make sure who they are through a photo check.”
One anecdote, Murphy shares is about a retired nun who served as a missionary in Portuguese-speaking Brazil for 30 years and became a volunteer interpreter for Malta. “When people heard we had Sister Betsy more Brazilian patients appeared,” Murphy said.
In the COVID-19 environment, both the need and the complexity of providing this care was magnified by several factors.
Many patients are employed at higher risk and lower-pay essential industries, such as supermarkets, pharmacies and take-out, and drive-in eateries. They also are a major presence among hospital and emergency response personnel.
Moreover, many patients are susceptible to a severe, even deadly case of COVID-19 because of underlying conditions. A significant number have diabetes or asthma, Murphy said. Other issues include obesity, high blood pressure, or high cholesterol levels.
As the pandemic continues staffing has been a challenge. For now, Malta House of Care relies almost entirely on its paid professional staff. Volunteers were invited to return but most were reluctant due to the risk of infection by the coronavirus. “Many are older with underlying medical conditions,” Murphy explained.
In a typical year, the medical volunteers donate 1,300 hours of free care, Murphy said.
The genesis of Malta House of Care began in 2004 when the Hartford area members of the Knights and Dames of Malta recognized a need to help address disparities in health care access and quality impacting poorer residents.
Working with financial assistance and guidance from St. Francis Hospital, then-Archbishop Henry Mansell of the Archdiocese of Hartford and community leaders, the founders of the House of Malta decided that a mobile clinic would be the best model.
Another decision was that health care would be delivered at safe sites, local churches, in the neighborhoods where it was needed the most.
On July 9, 2006, the program debuted and greeted its first patients at St. Peter’s Church on Main Street in Hartford. The first year, House of Malta recorded 477 free patient visits.
In 2019, the Hartford Foundation for Giving provided a $195,000 grant or nearly half the cost of a new van. It costs $87,500 a month to operate the van, and this is supported entirely by donations.
“We rely on the remarkable generosity of foundations, corporations, family funds, individual donors, and partnerships with institutions like the Archdiocese of Hartford; Saint Francis Hospital & Medical Center; Hartford Hospital; the University of Saint Joseph; and the Eastern CT Health Network/University of New England College of Osteopathic Medicine.
Other supporters include Aetna, CIGNA, the Hartford, and the Bank of America. In addition, Malta House of Care receives a portion, about $150,000, of the Archdiocese of Hartford’s annual appeal.
Malta’s major fundraising event is its Celebrating Wonder Women dinner which is held in October and honors seven women of achievement.
In 2020, Malta House of Care is utilizing a grant from CVS to provide annual eye exams for diabetes.
Another grant, from Connecticut-based Boehringer-Ingelheim, covers the cost of a 12-month health coaching program which Murphy said has produced good results.
Looking forward, the Malta board is expected to adopt a strategic plan to meet as “best it can” an anticipated “surge” in the demand for services. “As unemployment soars, so too will the number of people without health insurance – and the number of patients seeking care at the Malta van,” Murphy said.
Malta hopes to expand the mobile clinic’s hours, now six-hours at each stop, and based on insights from the telemedicine experience to increase the number of patients treated at the Woodland Street office.
The care that Malta provides to poor, minority communities has gained recognition on several levels, including the National Association of Free and Charitable Clinics’ highest rating.
Megan Burke, senior community investment officer for the Hartford Foundation for Public Giving, one of the clinic’s longtime supporters, expressed pride in this relationship which included underwriting half of the cost of a new van a few years ago.
“Supporting these vital health care services for so many of our region’s low-income residents of color, including immigrants, makes a major contribution to the Foundation’s efforts to reduce disparities based on race, place and income in Greater Hartford,” Burke said.
The mobile clinic typically follows this schedule:
Monday, 9am-3:30pm, St. Rose Church, 33 Church St., East Hartford
Tuesday, 11am-3:30pm, Cathedral of St. Joseph, 134 Farmington Ave., Hartford
Wednesday, 10am-1:30pm, Cathedral of St. Joseph, 134 Farmington Ave., Hartford
Thursday, noon-3:30pm, St. Augustine Church, 10 Campfield Ave., Hartford
Patients must wear masks; those with flu-like symptoms or other questions should first call Malta’s office at 860-725-0171.
Publisher’s Note: Cover photo is of Drive-Through COVID Testing Moves to New Site at St. Francis