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Medical self help: building a clinic from the ground up



It's a typical day for Carmen Velasquez, executive director of the Alivio Medical Center. Her phone rings madly as she searches through a neatly stacked pile of papers on her desk, looking for a document explaining how much it will cost to expand the center at 2355 S. Western. She's talking to this reporter after just concluding an interview with another. She's got a staff meeting after lunch and a business meeting with funders after that. Meanwhile, the reception area downstairs is bustling with patients. "It's always kind of hectic in my life," says Velasquez. "With the award it's got even more hectic."

She's referring to this year's Sara Lee Foundation Chicago Spirit Award, a $50,000 grant distributed each year to a not-for-profit group for outstanding leadership, sound management, and innovative programs. This year it went to Alivio.

Alivio is a not-for-profit health center that services the largely Mexican American communities of Pilsen, Little Village, and Back of the Yards. It has a staff of 58, a budget of $2.6 million, and about 22,000 patients a year. Most of the staff is Mexican American. "This is a Latino organization," says Velasquez. "We're very proud of who we are."

Velasquez comes from one of the city's more ambitious families: Her father, Arturo, founded Velasquez Automatic Music, a highly successful jukebox company. Her brother Arthur oversees Azteca Foods, a tortilla-making operation. Two other siblings, Edward and Maria Elena, now oversee most of the day-to-day operations of the jukebox company. Along with her mother, Shirley, they are all prominent fixtures in southwest-side political and social organizations.

Velasquez herself is a former member of the Chicago Board of Education and part owner of Decima Musa, a Mexican restaurant in Pilsen. Like her parents and siblings she has close ties to the Daley administration. "When Mayor Daley sees my family at gatherings he will publicly recognize the energy and work my parents have given to the city," says Velasquez. But she's no brownnoser. "I'm a little more confrontational than the other members of my family. I have that reputation. If you mess with me, I'll mess with you right back."

The idea for the clinic came from Ann Garcelon, a friend of Velasquez: "Ann is a doctor with a practice at 46th and Ashland, which is the Back of the Yards. She had privileges at Mercy Hospital. When she'd go there she would look around and wonder, 'Where are the brown faces?' Mercy is close to Latino communities here, yet there were few Latino patients." So in 1986 Garcelon and Velasquez initiated a meeting with Mercy's director, Sister Sheila Lyne, who has since become commissioner of the city's health department.

"We went to Sister Sheila and said, 'Where are the Mexicans?'" says Velasquez. "And Sister Sheila said, 'We didn't know there's a need.' Now in fairness to Mercy and Sister Sheila, they could have gone to the suburbs, but they stayed in the city. They just didn't have a relationship with the Latino community. So they began to address that problem."

An ad hoc committee was formed that included Velasquez and Lyne. "We had one major demand or expectation," says Velasquez. "The community had to lead. This had to be a community clinic, not a Mercy clinic. They were very cooperative. Mercy is run by the Mercy nuns, so there is a mission there. You're talking about a group of women who run hospitals to service the needy. They never got into a big ego thing with us."

Mercy agreed to help finance the new clinic; it also received start-up funding from the Chicago Community Trust.

"We had a good partnership with Mercy," says Velasquez. "Their development person, Za Noorani, is good at what she does. She does the research. She identifies all the sources for grants and contributions. She makes the calls, and then we come in and do the dog-and-pony shows."

Throughout 1987 Velasquez and other community leaders, including Vincent Allocco, executive director of the Pilsen-based social service organization El Valor, took funders on tours of the neighborhood. "We would drive them through the community and tell them about problems of housing, education, and lack of jobs," says Velasquez. "We stressed how we have to think of health needs as they fit into wider community issues."

The communities in question roughly follow the curve of the Chicago Sanitary Canal as it runs southwest from 16th Street to 55th Street and include about 180,000 residents, many of them recent immigrants. "We would tell prospective funders that our population is young and includes many women of child-bearing age," says Velasquez. "There are problems of diabetes, asthma, obesity. A lot of people don't have insurance. There are only two other clinics in this area. We didn't want to compete with them. We're all here to serve."

Their first major challenge was to find a location for the clinic, a pursuit that took Velasquez and her allies on a door-to-door trek. "One snowy Friday afternoon Allocco and I were walking along Western going to each building and asking the owners, 'Are you selling?'" says Velasquez. "Then I saw this empty lot next to a muffler shop at 23rd and Western. I went into the muffler shop and asked if the lot's for sale, and the guy says, 'Offer me something.' I went back to our ad hoc group and said we have to start a capital development campaign--we have a site."

They raised $2.1 million, $1 million of it from the Coleman Foundation, to buy the land and build and outfit the health clinic. They built a bright, airy two-story facility.

"Someone who came here said, 'Is this the Taj Mahal?' Meaning that it was so nice for a not-for-profit clinic," says Velasquez. "I said, 'What do you want, a storefront?' Why can't a clinic that serves low-income Latinos look nice?"

Maintaining the building can be a struggle, she says: "We have hundreds of people going through here all the time. I want it to look nice. I'm always picking up pieces of paper. I'll ask someone, 'How did this paper get here?' They'll look at me like it's some great mystery. I'm insistent about this. We have to maintain this clinic. We have to keep it nice. This is ours. I tell the staff: Only framed posters on the walls. It's the little things that count."

Most of Alivio's clients are on public aid, others are on medicare, and a few have private insurance. Among Alivio's programs is Nino a Nino ("child to child"), which teaches kids how to bathe, dress, and feed their younger siblings. There's also a program that tutors immigrant doctors so they can pass local licensing exams and practice medicine here.

In the next few months Velasquez hopes to raise almost $1 million and build five new examining rooms. "I would really like to expand our birthing program," she says. "We have a midwifery program with five midwives. My vision is for a birthing center."

The $50,000 grant will be used to hire what Velasquez calls a "guru nurse. That means a master's level, bilingual, hopefully bicultural nurse. That's my jargon, bicultural. It means Mexican. Or at least someone who understands this community."

The whole staff was invited downtown to receive the award. At an afternoon reception, they mingled with corporate hotshots who told them they were doing a wonderful job. "Our award recognizes Alivio Medical Center because of its leadership in providing superior health services to a population that has been severely underserved," said Robert Lauer, president of the Sara Lee Foundation, as he presented the award. "Alivio's success as a facility owned and operated by the Latino community is an inspiration to other communities throughout the state."

Velasquez closed the center on the day of the downtown function so the whole staff could attend the ceremony. But the next day it was business as usual.

Art accompanying story in printed newspaper (not available in this archive): photo/Peter Barreras.

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