Free Clinic

NYC
Free
Clinic
Bridging The Gap
Supporting the Uninsured of New York City
ANNUAL REPORT 2006-2007
Annual Report 2006-2007
Introduction
T
he New York City Free Clinic
(NYCFC), established in 2002, is
committed to ­serving the healthcare
needs of the uninsured of New York City.
The NYCFC provides its patients the full
range of healthcare services, including
social services, laboratory testing, and
outpatient specialty referrals. Central to
the mission of the NYCFC are both the
provision of the best possible care to its
patients and the educational experience for
its volunteers. With the tireless­commitment
of its organizational partners, volunteer
base, and management, the NYCFC is able
to provide an innovative and ­comprehensive
solution for the unfortunately large number
of uninsured New York residents.
The following report details organizational
developments and patient services statistics
between June 01, 2005 and May 31,
2007, NYCFC fiscal years 2005-2006 and
2006-2007.
Table of Contents
4
Organizational Partners
6
Article: Healthcare Crisis
7
Article: Supporting the Uninsured of
New York
8
History and Milestones of the NYCFC
10
Article: Team-Oriented Approach to
Care
12
Fiscal Year 2006-2007: Financial
Statement
14
Fiscal Year 2006-2007: Patient
Demographics
16
Fiscal Year 2006-2007: Patient
Services Statistics
18
Fiscal Years 2005-2007: Physician &
Student Volunteers
20
Appendix
22
Looking Ahead: A Vision to Better
Meet the Needs of the Uninsured
23
Credits
New York City Free Clinic
16 East 16th St
New York, NY 10003
(917) 544-0735
www.med.nyu.edu/nycfreeclinic/
[email protected]
2
Supporting the Uninsured of New York City
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
Steering Committee
Co-Director / Management
Co-Director / Development
Fundraising
Fundraising
Chief Financial Officer
MD Recruitment
MD Recruitment
Laboratory Services
Laboratory Services
Patient Scheduling
Patient Scheduling
Referrals
Referrals
Public Relations
Patient Advocate
Volunteer Scheduling
Undergraduate Volunteer Coordinator
Outreach Coordinator
Webmaster
Maura Madou
Jolyn Taylor
Rena Malik
Rushi Parikh
Marc Ialenti
Jonathan Baghdadi
Sajan Patel
Pritha Gupta
Rose O'Rourke
Elizabeth Gurney
Nathaniel Smilowitz
Brad Kligman
Emily Stamell
Mansi Shah
Pragati Tandon
Radhika Bauer
Sara Rostanki
Gilda Boroumand
Robert Baumgartner
Steering Committee Advisors
IFH NYCFC Medical Director
IFH Medical Director
IFH-NYCFC Advisor
NYCFC Faculty Advisor
NYU SOM Dean for Student Affairs
NYU SOM Director of Student Affairs
Amarilys Cortijo, MD
Daniel Blumkin, MD
Sarah Nosal, MD
Joseph Cavanaugh, MD
Lynn Buckvar-Keltz, MD
Joseph Oppedisano
Abbreviations used in this report:
The New York City Free Clinic is made possible
through the partnership of:
IFH: Institute for Family Health
FY: fiscal year
NYCFC: New York City Free Clinic
NYU: New York University
NYUMC: New York University Medical Center
NYU SOM: New York University School of Medicine
MSI, II, III, IV: medical student, year of medical education
New York University
School of Medicine
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
3
Annual Report 2006-2007
Organizational Partners
T
he NYCFC is able to provide comprehensive
free care because of the commitment of
its organizational partners, volunteer
base, and management.
Bringing healthcare to the uninsured requires
clinic space, laboratory services, pharmacies,
and referrals for specialty care, not to mention
the time and skills of dedicated physicians,
students, technicians, and administrators. To
meet these requirements, the NYCFC formed
agreements with a number of hospitals, clinics,
and non-profit organizations throughout New
York City known for their commitment to the
uninsured.
Primary among them are:
The Institute for Family Health:
The Institute for Family Health (IFH) is
one of the two founding collaborators of
the NYCFC and is the clinical operator
of the NYCFC. It is an active part of the
NYCFC Administrative Board and Steering
Committee. IFH supports the NYCFC by
generously donating all the clinical space
used by the NYCFC while open on Saturdays,
as well as associated maintenance, medical
supplies, social workers, patient service
representatives, and medical staff time. The
NYCFC also collaborates with IFH to provide
prescription drugs at a greatly reduced cost
to patients through the federal 340B Drug
Pricing Program.
New York University School of Medicine:
NYU School of Medicine (NYU SOM) is the
other founding collaborator of the NYCFC. It
provides extensive administrative support,
invaluable advising, and numerous services
to the NYU medical students who volunteer
at and manage the clinic. NYU SOM donates
all administrative office space, associated
maintenance, office supplies, financial
accounting and auditing, and covers many
costs associated with student volunteers.
4
Supporting the Uninsured of New York City
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
1<80HGLFDO&HQWHU
6FKRRORI0HGLFLQHDQG+RVSLWDOV&HQWHU
Bellevue Hospital Center:
New York University Medical Center:
New York University Medical Center (NYUMC)
graciously donates all laboratory supplies and
all laboratory services offered by the clinic,
including blood tests, urine analysis kits, Pap
smears, radiological services, and sexuallytransmitted infection testing, among many
other laboratory services. By providing these
services at no cost to the patient, the NYUMC
plays an invaluable role in providing quality
healthcare for the uninsured.
New York City’s Bellevue Hospital Center,
the nation’s oldest public hospital, has
a long-standing history of caring for the
underserved communities throughout New
York City. Bellevue graciously entered into
an agreement with the NYCFC to charge a
deeply reduced cost for outpatient specialty
referrals. This reduced cost permits the
NYCFC to refer its patients to Bellevue
Hospital free of charge to the patient, as the
NYCFC is able to cover (through fundraising
efforts) the reduced cost of the specialty
appointment. The NYCFC is the only free
clinic in New York City that provides such
referrals free to its patients.
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
5
Annual Report 2006-2007
Healthcare Crisis
N
ew York City is currently facing a large
scale crisis with over 1 million of its
residents lacking health insurance
coverage1. This means that one in six New
Yorkers is either paying out of pocket for
the increasing expenses of medical care, or
sacrificing necessary care. While most may
assume this is a problem stemming from
unemployment, in fact more than two thirds
of uninsured New Yorkers are employed1.
The high rates of uninsured New Yorkers
are fueled by the high costs associated with
insurance premiums. The average monthly
premium for an individual HMO plan in New
York City is $8372. This includes the poorest
neighborhoods of the South Bronx, East
and Central Harlem, and North and Central
Brooklyn where more than 1 in 3 residents
live in poverty and are unable to afford
this additional expense3. Many employers
have also increased the percentage of the
premium that their employee must pay or
have stopped offering coverage options to
their employees. Since 1996, premiums
have risen by percentages well above the
rate of increase of both workers’ earnings
and inflation4. Access to health insurance has
therefore been limited to the upper classes or
those fortunate enough to have it provided
by their employer.
Due to the high cost of insurance premiums,
New York does offer some public insurance
programs for low-income families. In addition
to Medicare and Medicaid, programs such
as the State Children’s Health Insurance
Program (SCHIP), Family Health Plus and
Child Health Plus provide access to health
care for the poorest residents. However, the
requirements to qualify for these programs
are often so stringent that many middle-class
families don’t qualify, yet they are also unable
to afford insurance premiums. This increases
the risk of being uninsured as an adult in a
low-income family. For example, a family of
two parents and one child, cannot exceed the
maximum gross annual income of $25,755
in order to qualify for the Family Health Plus
program5. A problem arises for any family
making slightly more than the cutoff because
they are still unlikely to be able to afford even
the least expensive insurance premium with
the high cost of living in New York City.
In addition to the financial strain that a lack
of health insurance puts on a family, it also
leads to the overuse of hospital emergency
departments and insufficient preventive care
from a regular provider. In 2004, it was found
that 65% of non-elderly, uninsured adults
in the United States visited the emergency
room at least once within the last two years.
In comparison, only 27% of insured adults
went to the emergency room in the same
time frame6. Many emergency departments
are being overwhelmed by non-emergent
cases because the uninsured are turned away
from many other clinics which require them
to pay out-of-pocket. In addition, 41% of
uninsured New Yorkers reported that they
did not receive necessary medical care in the
last year, as compared to 11% of insured New
Yorkers7. Many serious health problems, such
as diabetes, hypertension and asthma can be
prevented or better managed by visits to a
regular provider. Unfortunately, it is difficult
for most uninsured families to regularly visit a
doctor, leading to unnecessary complications
which may have been avoidable with good
preventative care, such as that which the
NYCFC is able to provide as a short-term
solution for their patients.
As many New Yorkers find themselves without
health care, it is increasingly important that
the health insurance system be expanded to
provide access to more people. However, the
transition to a more comprehensive insurance
system is complex and in the meantime it is
essential that other resources are developed
and expanded to help those who have been
left out. (Please see Page 23 for References)
6
Supporting the Uninsured of New York City
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
Supporting The Uninsured
O
ur services are meant to be an
initial stop for patients on their way
to entering the health care system
so they will receive the same quality and
continuity of care as insured patients. The
only current criterion to receive care at the
New York City Free Clinic (NYCFC) is that
an individual be uninsured and ineligible
for government insurance programs. The
Institute for Family Health (IFH) provides
every potential NYCFC patient with free social
work services including health insurance
screening and assistance with registration
for government health insurance, and other
screening and counseling services when
appropriate. These services allow the NYCFC
to not only provide comprehensive primary
medical care only to those patients who truly
qualify, but also to serve as a key access
point for uninsured patients by facilitating
the process of entering New York’s health
care system.
of
New York
Patients who have complex or chronic illnesses
are transferred to one of the IFH health centers
for regular care, or the patient works with
the social workers and medical providers at
the IFH to determine an alternative solution.
Student volunteers also provide an extensive
and current list of free and low-cost health
services in New York on the NYCFC website.
The NYCFC provided 1207 patient
visits, serving 591 uninsured New
York residents from June 2005 to
June 2007.
With these goals in mind, prior to receiving
an appointment at the NYCFC, all patients
are screened for Medicare, Medicaid, and
Family and Child Health Plus eligibility,
as well as for any temporary insurance
programs. When eligible, the social workers
facilitate the application process to ensure
successful enrollment. The NYCFC also helps
patients find a primary care provider that
is convenient for them once the insurance
application process has begun.
If a patient is deemed ineligible for government
insurance programs, he or she is welcomed
as a patient of the NYCFC, and is eligible for
comprehensive primary care services on site,
specialty referrals at Bellevue Hospital free
of charge, and low cost prescriptions secured
through agreements between the IFH and
local pharmacy programs. From June of 2005
to June of 2007, the NYCFC provided 1207
patient visits, serving 591 uninsured New
York residents.
Check out our Website:
http://www.med.nyu.edu/nycfreeclinic/
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
7
Annual Report 2006-2007
History
and
Milestones
T
hree New York University (NYU) medical
students established the NYU Free Clinic
Project in the fall of 1999 with a vision
of opening a free clinic to serve the patients
falling through the cracks in the healthcare
system. One year later, what was then called
the Institute for Urban and Family Health (now
called the Institute for Family Health) partnered
with NYU School of Medicine (NYU SOM) to
form the New York City Free Clinic (NYCFC),
housed at IFH’s 16 East 16th Street location
in Manhattan.
opening, IFH received substantial funding from
the Starr Foundation to support operational and
administrative costs. The Starr Foundation has
continued its strong financial support of the
NYCFC over the past five years.
Costs for patient laboratory testing and referrals
have been waived or subsidized through
agreements with NYU Medical Center and
Bellevue Hospital. Any remaining potential
visit costs to the patient are covered by the
tireless fundraising efforts of NYU medical
students. Patients also benefit from reduced
The Association of American Medical Colleges cost pharmacy programs put in place by IFH.
(AAMC) and Pfizer awarded the NYCFC the
Caring for the Community startup grant in late In 2006, the Langeloth Foundation awarded
2000. With the management infrastructure in the NYCFC with a generous grant for clinic
place by the spring of 2001, the NYCFC opened expansion. The funds have thus far been used
to the public on March 9, 2002.
to reach a larger patient base by increasing
the number of clinical teams available to see
Since its inception, the NYCFC has operated year- patients on Saturdays as well as by holding
round on Saturdays from 9:00AM to 3:00PM health screening outreaches in different New
with an all-volunteer student administrative York boroughs. This grant has also made
staff committed to serving the uninsured of possible a collaboration with the Reproductive
greater New York. One month after the grand Health Access Project to create a women’s
health clinic.
NYCFC History Timeline
Fall
1999
Fall
2000
NYU Free
Clinic Project
established by
NYU medical
students
Winter
2000
AAMC Caring for
the Community
founding grant
awarded
IUFH partners
with NYU Free
Clinic Project
to form NYCFC
8
Spring
2001
March
2002
NYCFC opens
Saturday
clinic
NYCFC Steering
Committee
formed
Supporting the Uninsured of New York City
April
2002
December
2004
March
2005
AMA Foundation
grant for
health prevention
& research awarded
Starr Foundation
grant awarded
NYCFC relocates
to larger clinic
space, adopts
electronic
medical records
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
Milestones June 2005 - May 2007
Milestones June 2004 - May 2005
•
NYCFC was awarded American Medical Association ­Foundation
Grant to research and implement better patient health
education and disease screening.
•
NYCFC obtains new clinic space with more exam rooms
providing opportunity for future clinic growth.
•
NYCFC switches from paper charts to IFH's Electronic ­Medical
Record system for more efficient and effective patient
charting and data collection.
•
NYCFC increases continuity of care by receiving consult
reports for referrals appointments at Bellevue Hospital.
•
NYCFC adopts new scheduling protocol to increase ­efficiency
and number of patients seen per Saturday.
•
NYCFC implements new patient demographic survey to better
assess patient population.
Spring
2006
•
The Langeloth Foundation awards NYCFC a substantial sum
to be used for expansion of patient services at the clinic.
•
The number of clinical teams are increased and urgent care
appointments are added, using the Langeloth grant.
•
Community Health Screening Outreaches begin in boroughs
around New York City, using the Langeloth grant.
•
The Labs coordinators (two student volunteers) and Tisch
Central Labs agree to begin liquid pap smears and reflex
HPV testing for our female patients.
•
NYCFC and IFH work together to improve health care access
by extending patient access to the main IFH phone lines for
scheduling and medical questions every day of the week as
well as for after-hours care.
•
The referrals coordinators (two student volunteers) work with
Bellevue Hospital to minimize referral costs to the NYCFC
and begin offering colonoscopy for the subsidized cost of a
routine visit.
•
NYCFC partners with Reproductive Healthcare Access Group to
open a women’s health clinic every other Saturday beginning
February 2008.
September
2007
November
2007
December
2007
Lab services
begin to include
PAP smears and
HPV testing
Phone service
extends hours
and expands
to every day
of week
Lab services
begin to include
PAP smears and
HPV testing
Langeloth Foundation
grant for expansion
of services awarded.
Clinical teams expanded
Community Health Screening Outreaches
commence in boroughs of NYC
February
2008
Women's
Health Clinic
at NYCFC
opens
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
9
Annual Report 2006-2007
Team-Oriented Approach
I
to
Care
n addition to addressing the healthcare a differential diagnosis under the supervision
needs of New York’s uninsured, the of a physician preceptor, the clinical team
NYCFC serves as an invaluable tool in presents
d u cthe
a t icase
o n to
i s the
c eattending
n t r a l t physician
o the
the education of all its volunteers. From in order
to
assess
and
develop
healthcare
NYCFC mission. It is a
manifested
pre-medical undergraduates to pre-clinical plan for the patient. Moreover, two medical
in virtually every aspect
(1st and 2nd year) and clinical (3rd and students gather specimens for any lab tests
o
f
t
h
e cand
l i n ianother
c , f r opre-clinical
m t h e Nstudent
YCFC
4th year) medical students, New York ordered,
m i n i s t ra t i oall
n the
t o referrals
t h e S a trecommended
u r d ay c l i n i c
University students at all stages of theira dcoordinates
medical training participate in all aspectssessions.
by the clinical teams. The medical students
of the clinic.
are supported by undergraduate students
who perform administrative
tasks such as
Administratively,
a Steering Committee
of
During the Saturday clinic sessions, a team-seventeen
registering
patients at
themedical
front desk
and
second-year
NYU
students
oriented approach to care is emphasizedmanages
scheduling
appointments.
These
thefollow-up
executive
operations of
the
as student and physicians teach andclinic,
undergraduates
also
have
the
opportunity
gaining direct experience not only in
learn from each other. Teams of one pre- to shadow the clinical teams in the exam
how to run an urban primary care clinic, but
clinical and one clinical medical student rooms.
have the opportunity to put into practicealso in developing a cost-effective model for
healthcare
in New
York sessions
City. Additionally,
the skills and the knowledge acquired infree
Enabling
these
clinical
are the
five
fourth-year
medical
students
serve
as
classes. After recording medical histories, members of the Steering Committee who,
conducting physical exams, and generating with the support of IFH administration,
manage the executive
undertakings of the
NYCFC. The Steering
Committee includes 19
second year medical
students who manage
all aspects of the
NYCFC , financially and
administratively. Also on
the Committee are two
clinical students acting
as liaisons to the six
clinical coordinators who
oversee the activities
during the Saturday clinic
sessions. In this way,
the medical students on
the Steering Committee
gain direct experience
in the administration
and management of
an urban primary care
clinic.
10
E
Supporting the Uninsured of New York City
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
Over the years, the NYCFC has developed a
comprehensive set of free services available
to Clinic
all patients,
and to
the
Clinic acontinues
Coordinators
provide
stable liaison
to
expand
its
services
in
order and
to ensure
between the Steering Committee
the Saturday
access
to
quality
healthcare
regardless
of
clinic sessions while adding their clinical experience
personal financial status. Working within
"We work in teams to ensure
to the management team.
this model, students learn the practice of
medicine in its purest form, where only
the education of volunteers
During
Saturday
clinicissessions,
volunteers
the
patient’s
health
the top priority
in at all
and the best care for
points in their
training are
involved in all
developing
themedical
best treatment
plan.
aspects of patient care. A team-oriented approach
New York's uninsured."
Whether
a member
of the and
clinical
to care isbeing
emphasized
as student
physician
teams
during
sessions
- R. James Toussaint, MSIV
volunteers
teachthe
and Saturday
learn from each
other.or
Medical
contributing
to
the
extensive
coordination
teams composed of one preclinical and one clinical
and
organization
goes on
behind
medical
student gainthat
experience
in seeing
patients
the scenes, volunteering with the NYCFC
by taking medical histories, conducting physical
affords students an invaluable opportunity
exams,
andtheir
generating
a differential
to
enrich
medical
education.diagnosis.
At
The student
volunteers
thenengage
present in
thethe
patient’s
the
same time,
students
case to the by
physician,
and local
together
they develop
community
addressing
healthcare
an assessment
and plan
provide the
best care
access
disparities.
Whileto providing
care,
NYCFC
learn first-hand about the
possiblevolunteers
for each patient.
challenges and health disparities affecting
the
millions
of uninsured.
Students
areat the
Yet the
experience
that volunteers
gain
NYC Healthcare Facts
exposed
to
public
health
issues
and
are
NYCFC extends far beyond the provision of care.
1 million adult New Yorkers (1 in 6) are
able
how
these
issues translate
to learn
Fromto
a see
public
health
perspective,
students
the exam room, how they can adversely
without health insurance.
about both
the challenges
health
affect
the health and
status
of andisparities
individual facing
the millions
of uninsured,
see firsthand
47 million Americans lack health insurance.
and
the administration
of and
healthcare
to a the
importance
of
making
a
difference
one
patient
at
a
population. This combination of witnessing
Another
500,000 New Yorkers have time.state
Working
with and providing
to care for
the
of healthcare
for the access
uninsured
inconsistent coverage.
some
ofYork
New City
York’s
most
populations,
in
New
and
of underserved
being proactive
in
community
the volunteerinvolvement
management prepares
and clinicalfuture
teams learn
3/4 of all uninsured New Yorkers are physicians
advocate
for their
to confront to
andbetter
overcome
the many
barriers to
employed.
patients.
healthcare access.
41% of the uninsured report that they
have refrained from seeking medical care
The NYCFC has developed a uniquely comprehensive
due to cost.
set of free services available to all patients, ensuring
that access to quality healthcare will not be dictated
by personal financial status. This model of free
Source: Healthcare Access Among Young Adults in New
comprehensive care also allows physicians and
York City. A report from the NYC Department of Health
and Mental Hygiene, May 2007.
students to practice medicine in its purest form,
where only the patient's wellbeing is considered in
developing the best treatment plan.
Volunteering with the NYCFC is integral to the
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
11
F i n a n c i a l Re p o r t 2 0 0 6 - 2 0 0 7
Fiscal Efficiency
T
he NYCFC has developed an operational
model to provide comprehensive and
quality care for the maximum number
of uninsured patients possible given its
current level of funding.
Funding & In-Kind Contributions
FY 2006-2007:
while offering the highest quality care and
full range of services to the greatest number
ofd patients.
ucation is central to the
E
NYCFC mission.
It is manifested
Students
raised
the
in
virtually
efollowing
very
afunds
s p e ctot
budget.
o f tcontribute
h e c l i n ito
c , the
f r NYCFC
om th
e N Y CThe
FC
NYCFC's
three
main
funding
sources
during
administration to the Saturday clinic sessions.
FY 2006-2007 were:
Administratively, a Steering Committee of seventeen
1. NYU
Supplemental
Funding and
The NYCFC received essential in-kind
second-year
NYUSOM
medical
students manages
the
Student Council
contributions from three main sources during
executive operations
of the Funding
clinic, gaining
direct
fiscal year (FY) 2006-2007:
experience
not only in how to run an$7,030
urban
2.
Langeloth
Foundation
Grant
primary care clinic, but also in developing a cost
$22,399
1. Institute for Family Health/Starr
effective model
for free healthcare
in New
York
3.
NYU
SOM
Student
Fundraising
efforts
Foundation – clinic space, administrative
City. Additionally, five fourth-year medical students
437
overhead, medical director, psychosocial
serve as Clinic
Coordinators to provide$31,
a stable
services, medical supplies
liaison between the Steering Committee and the
2. NYU Medical Center – laboratory and
IFH supports the NYCFC by donating
radiology services
3. Bellevue Hospital Center – reduced clinic space and medical supplies, thereby
eliminating overhead costs. IFH also provides
cost specialty referrals
the NYCFC medical directors and advisors
Virtually all financial contributions made to the and clinic social workers. NYUMC remains
NYCFC go directly to providing patient care. committed to supporting the NYCFC by
The NYCFC has no overhead costs because providing all laboratory and radiology services
clinic space and medical supplies are donated offered by the clinic. Bellevue Hospital Center
by IFH through the generous support of the remains committed to supporting the NYCFC
Starr Foundation. Additionally, all laboratory by providing specialty referrals at a reduced
and radiology services are provided free cost to the clinic, enabling the clinic to refer
of charge by NYU and Bellevue Medical patients to Bellevue Hospital Center at no
Centers. Therefore, all clinic funding raised cost to the patient.
by NYCFC students is directed to specialty
referrals, patient education materials, and Budget FY 2006-2007:
other essentials of the NYCFC’s uniquely
The NYCFC annual student-raised operating
comprehensive patient care.
budget for FY 2006-2007 was $51,246. With
To minimize these costs, the clinic has this money as well as our in-kind contributions,
developed collaborative relationships with a the NYCFC was able to provide care to an
number of hospitals, clinics, and nonprofit average of seventeen patients per Saturday
organizations throughout New York City. for a total of 662 visits. Of the total budget,
The NYCFC remains committed to seeking $44,000 went to specialty referral services,
innovative solutions to minimizing costs while the remaining $7246 was distributed
between volunteer support materials and
12
Supporting the Uninsured of New York City
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
training ($2,752), telephone services
($366), patient education materials
and office supplies ($1,365), Steering
Committee meeting expenses ($1,036),
specimen and materials transport ($456),
and $1,271 went to volunteer support and
miscellaneous materials for both the clinic
and community outreach teams. Even
with the innovative and highly effective
cost-reduction model employed by the
NYCFC, the current budget limits the ability
to serve additional patients and implement
new prevention and outreach strategies.
Since 2005, the NYCFC has continuously
campaigned to secure additional funding in
order to sustain current patient services;
to allow for the expansion of services on
Saturdays; to add an additional clinic
devoted to women's health services; and
to support community health outreach
initiatives. Only with continued and
additional financial support can the NYCFC
better meet the health needs of New York's
uninsured patient population.
Income Statement 2006-2007*
Sources of Funding
Fundraising
Langeloth Foundation Grant
NYU SOM Student Council
Total Funding
$31,437
22,399
7,030
$60,866
Expenses
Referral Services
$44,000
Volunteer Support Materials & Training
2,752
Telephone Services
366
Patient Education Materials & Office Supplies 1,365
Steering Committee Meeting Expenses 1,036
Specimen & Materials Transport
456
Miscellaneous
1,271
Total Expenses
$51,246
* This income statement does not reflect in-kind contributions from
the Institute for Family Health/Starr Foundation, New York
University School of Medicine, New York University Medical Center,
and Bellevue Hospital Center.
Student-Raised Finances
for the Past Three Fiscal Years
70,000
60,000
50,000
40,000
30,000
20,000
Funds (In Dollars)
10,000
0
2004-2005
Saturday clinic sessions while
adding their clinical experience
to the management team.
2005-2006
2006-2007
Fiscal Year
Income
Spending
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
13
F i n a n c i a l Re p o r t 2 0 0 6 - 2 0 0 7
Patient Demographics
T
he NYCFC has expanded and
diversified its patient population
in each year of operation. During
FY 2006-2007, the NYCFC served 335
patients during 662 patient visits.
14
Supporting the Uninsured of New York City
New York Patient Population
Residence and Fiscal Year
by
During FYs 2005-2007, the NYCFC served
patients from 30 of New York City’s 34 communities as defined by the New York City
Department of Health and Mental
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
Hygiene Community Health Survey 2003.
Indicated on the map is the number of NYCFC patients from each New York City community during the past two fiscal years.
Data are presented as number of patients
from each community in FYs 2005-2007.
Total FY 2006-2007 Patient Population by Residence
Staten Island
3.0%
Total FY 2006-2007 Patient Population
by Residence
Bronx
4.6%
Queens
21.9%
During FY 2006-2007, the NYCFC served
patients from all five boroughs of New York
City. The majority of our patients come from
Manhattan and Brooklyn.
Brooklyn
35.0%
Since the NYCFC's opening in March 2002,
the number of ­patients has increased annually across all age groups. FY 2006-2007
saw a majority of patients between the ages
of 18 and 35, with the largest group consisting of patients aged 26-35 years. This has
been a consistent trend since the clinic's inception.
Manhattan
35.4%
Patient Age: Fiscal Year 2006-2007
120
100
80
60
40
20 of Patients
Number
0
Under 18
18-25
26-35
36-45
46-55
56-65
66+
Patient Age (Years)
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
15
F i n a n c i a l Re p o r t 2 0 0 6 - 2 0 0 7
Patient Services Statistics
P
atients come to the NYCFC with a
variety of health concerns and medical
conditions. It is therefore essential
that the NYCFC offer comprehensive free
­services, which are widely utilized by clinic
patients.
Most Common Chief Complaints by
Category FY 2006-2007
autoimmune, chest pain (cardiovascular or
­heartburn origin), cyst, domestic violence,
hernia, lump, ­prescription refill, and
shortness of breath.
Most Common Referrals to Bellevue
Hospital, by Specialty FY 2006-2007
Gastrointestinal, Mammography, Obstetrics
and
Gynecology,
and
Ophthalmology
Data indicate that health maintenance, comprise the top four specialty referrals
obstetrics and gynecology, and "Other" made by the NYCFC during FY 2006-2007.
comprise the majority of NYCFC patients' A total of 175 specialty referrals were made
chief complaints during FY 2006-2007.
by the NYCFC to Bellevue Hospital Center
during this time. All ­specialty referrals are
Health Maintenance includes immunizations free to the patient.
and physicals as well as preventive medicine
and laboratory follow-ups. "Other" includes
Most Common Chief Complaint by Category FY 2006-2007
Respiratory (3.1%)
Psych
(3.6%)
Allergy/Immuno (1.8%)
Cardiology (8.5%)
Other
Chief
(9.9%)
Most Common
Complaints
by Category FY 2004-2005
Most Common Referrals to Bellevue
Dermatology (6.1%)
Hospital Center by Specialty FY 2004Endocrine (4.8%)
ENT
(3.1%)
GI
(5.2%)
OB/GYN
(14.4%)
GU/Renal
(4.2%)
MSK/Rheum
(5.4%)
Health Maintenance
(29.8%)
16
Supporting the Uninsured of New York City
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
2005-2006
2006-2007
Grand Total
BMP
51
42
93
Card.
7
7
14
CBC
87
59
146
Derm.
25
11
36
ENT
6
5
11
GC/Chlam.
53
66
119
GI
20
33
53
Gluc.
20
32
52
HbA1C
4
11
15
HIV
53
45
98
Lens Crafte
2
3 Prescribed ­Medications
Most Commonly
Ordered Lab1 ­Services Most
Commonly
LFT
47
29 2006-2007
76
FY 2006-2007
FY
Lipid Profil
123
89
212
29
26total of 389 prescriptions
55
The seven Mamm.
most commonly ordered
lab A
were ­written by
OB/GYN
17 NYCFC during
45 FY 2006-2007. The 15 most
­services at the
NYCFC during FY28
2006-2007 the
16
33
were: lipid Ophth.
profile, Gonorrhea &17Chlamydia common
­medications
fell into the following
Ortho.
14
5
19
(GC/Chlam.), Pap smear, complete blood therapeutic ­categories: allergy and cough
Other
188 hormone 124
312
count (CBC),
­thyroid stimulating
(Flonase, Nasonex),
asthma (albuterol),
Pap
59
66
125
(TSH), HIV, and basic metabolic panel (BMP). ­cardiovascular ­(hydrochlorothiazide, Lipitor,
PT lab tests were ordered
3
4
7
A total of 811
during metoprolol,
quinapril),
­c ontraceptive
32
73
this period. RPR
All ­laboratory tests41are free to (Microgestin,
Orthotricyclen), diabetes
7
5
12infection (ketoconazole,
the patient. Surgery
(metformin),
TSH
57
56
113 mental health (trazodone,
metronidazole),
UA
38
24
62
Zoloft),
pain (aspirin).
X-Ray
8
6
14
Fiscal Year 2006-2007
140
124
Number of Labs Ordered
120
100
89
80
60
66
66
59
56
45
42
40
20
33
7
11
5
32
29
32
26
17
11
24
16
5
2
4
5
6
0
Lab Type
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
17
Annual Report 2006-2007
Physician
and
Student Volunteers
A
ll students associated with the NYCFC
are volunteers and are not financially
compensated by the clinic. Volunteers at
the Saturday clinic are NYU medical students
and undergraduates, and physicians from
IFH, NYUMC, Bellevue Hospital Center, and
private practice. More than 600 students and
healthcare professionals have volunteered in
some capacity at the NYCFC since it opened
in March 2002. From 2005-2007, 9 physician
preceptors, 211 medical students, and 21
undergraduates volunteered at the NYCFC.
Physician Preceptors
Amarilys Cortijo, MD
Sarah Nosal, MD
Daniel Blumkin, MD
Robert Wolff, MD
Ginger Gillespie, MD
Linda Prine, MD
Elizabeth Molina-Ortiz, MD J Robbins Lines, MD
Ruth Lesnewski, MD
Daina Danovitch, MD
Six to seven supervised clinical teams, each
comprised of one clinical and one preclinical
medical student, see patients during the
Saturday clinic. Clinical teams present to the
attending physician preceptors on staff. Three
additional medical students serve non-clinical
positions performing laboratory services and
processing specialty referral requests, among
other functions. Four undergraduate students
manage the front desk, assist in conducting
patient surveys, and shadow the clinical teams
throughout the day. In total, more than twenty
students and physicians volunteer at the NYCFC
each Saturday. New student volunteers rotate
through the clinic every four months.
Steven Chan
Samyra El-ftesi
Mike Guarnieri
Richard Chang
Lauren Ende
Stacey Gunn
Jennifer Chen
Juliana Eng
Pritha Payel Gupta
Stephanie Cheng
Oren Erlichman
Liz Gurney
Zina Chepurny
Tom Facelle
Emily Hanson
Samir Chheda
Adam Fein
Jack Harbell
Vivian Chin
Daniel Fein
Asheesh Harsha
Bradley Ching
Emily Feingold
Melissa Herrmann
Veena Choubey
Miriam Fishman
Monica Ho
Reezwana Chowhurdy Francisco Folgar
Kumari Hobbs
Medical Student Volunteers
Tina Chu
Anthony Fontana
Jennifer Hoffman
Grace Chung
Catherine Ford
Jonathan Hoffman
Anu Abraham
Jessica Maria Atrio
Michelle Black
Jeremy Clain
Daniel Frenkel
David Hong
Nitya Abraham
Jonathan Avery
Adam Blaisdell
Jason Collins
Justin Friedman
Shuyan Huang
Melissa Acevedo
Diego Ayo
Eve Bloomgarden
James Crawford
Adam Gaffney
Anthony
Shivani Agarwal
Jonathan Baghdadi
Cassyanne Aguiar
Amar Bansal
Sarabeth Broder-Fingert John Cruz
Todd Cutler
Shanique Brown
Shawn Ahmad
Elaine Barfield
Kimberly Bucknor
Linda Galperin
Isenalumhe
Tian Gao
Rajat Jain
Peter Czobor
Al Garfall
Rachana Jani
Alex Gavlin
Rebecca Jessel
Benjamin Ge
Nancy Jiang
David Aizenberg
Maya Barghash
Alexis Burakoff
Manesh Dagli
Lourdes Al Ghofaily
Vanessa Batista
Charlie Butler
Adele Damlamian
Amber Alayyan
Robert Baumgartner Caprice Cadacio
Jennifer Danielsson Brian Ginsberg
Josh Allen-Dickler
Jeremy Beitler
Brooke Davey
Joelle Glick
Nicole Kaban
Quazi Al-Tariq
Sabina Berezovskaya Mariela Cantera
Jason DeBonis
Michelle Goldberg
Lana Katsnelson
Deepti Anbarasan
Jonathan Berliner
Joe Carey
Wojciech Dec
Jordana Firestone Goren Marra Katz
Elisa Aponte
Chris Betchel
David Carey
Michael DiLorenzo
Abby Green
Dan Asay
Mitesh Bhalala
Demetrio Castillo
Cindy Dodard
Vadim Gretchouchkin Lauren Kennish
Carolina Cernicica
Rachel Edlin
Michael Guarnieri
Amer Assal
18
Lara Bishay
Adrianna Campos
Supporting the Uninsured of New York City
Vicky Jones
Brian Keegan
John Keogh
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
(Continued) Medical Student Volunteers
Kevin Small
Katherine Khvilivitzky Allison Markowsky
Shaline Rao
Nat Smilowitz
Brian Kim
Kelly Maurelus
Tara Rao
Joshua Smith
Jolyn Taylor
Amy Yang
Jessica Kim
Anna Maw
Stephen Rawlings
Rick Smith
Vitaly Terushkin
Elaine Yang
Minjee Kim
Jeffrey Mayne
Justina Raynor
Daniel Soloman
Sayone Thihalolipavan Ben Young
Pablo Kim
Kira Melamud
Shivani Reddy
Christian Song
James Toussaint
Jonathan ZagZag
Carlene Kingston
Kavi Menon
Sruthi Reddy
Carina Sorenson
John Trahanas
Jeron Zerillo
Rebecca Kleinerman Michelle Mergenthal Derek Daniel Reformat
Jaclin Springer
Chizoba Umeh
Shugi Zheng
Brad Kligman
Emily Miller
John Reilly
Ramya Srinivasan
Levon Utidjian
Inna Zhitomirsky
Scott Koenig
Sarah Mitchell
Amanda Rubenstein
Emily Stamell
Alina Vaksman
Lauren Kornreich
Marisa Mizus
Nate Reyes
Teerath Peter
Martin Wolff
Tanpitukpongse
Andrea Stroud
Christopher Valente
Meredith Kursmark Carrie Morgenstein Monalyn de los
Patrick Sullivan
Maksim Vaynrub
Patrick Kwon
Shweta Motiwala
Joanne Sun
Christopher Velez
Juan Jose Lado
Elizabeth Moye
Barrie Rich
Gloria Sung
Kush Verma
Catherine Lau
Regina Mysliwiec
Tanique Richards
Nicole Sunseri
Karin Warltier
Ann Lee
Miriam Nazmy
Briana Riemer
Rupali Surendra Avasare Amber Wheeler
Annie Lee
Jeff Neil
Jordan Rihani
Jordan Swartz
Amanda Wilson
Catherine Lee
Vincci Ngan
Eric Riles
Pragati Tandon
Amelia Wnorowski
Grace Lee
Ade Olasunkanmi
Christy Riley
James Lee
Maribelis Olivares
Sylvia Rivera
Tom Lee
Jonathan Oren
Dave Robida
Jennifer Leung
Eleza Orenstein
David Robida
Brian A. Levine
Arielle Ornstein
Alexis Rodriguez
Seth Lieberman
Rose O'Rourke
Caroline Rosenberg
Brian Liem
Kristin Ow Chapman Jennifer Rosenberg
Emerson Lim
Jenny Pan
Sara Rostanski
Ilya Lim
Austin Pantel
Jared Rubenstein
Irene Isabel Lim
Rushi Parikh
Farrah Sajan
Clarence Lin
Susan Park
Lourdes Sanso
Edward Lin
Sajan Patel
Ryan Santos
Dan Lorch
Sunal Patel
Claritsa Santos Malavé
Reyes Labitigan
Eric Wong
Undergraduate Volunteers
Front Desk
Outreach
Jackie Cartier
Anne Sebastian
Angana Homchaudhuri
Hilary Mra
Naoreen Chowdhury
Kandy Bahadur
Tracie Lin
Sisi Guo
Aqsa Durrani
Tiffany Wu
Angelina Daysudova
Ria Nair
Dina Elachi
Shauna Kwok
Elinor Zhou
Saad Rasheed
Scheduling
Sanaa Somalya
Charlotte Seyon Marcus
Tiffany Hamil
Linda Kim
Anna Podolanczuk
Amisha Shah
Jessica Laifer
Kristina Dvorakovskaya
Michelle Ma
Rebecca Podolsky
Mansi Shah
Ria Nair
Ryan Macht
Michael Postow
Sarah Shalev
Tiffany Wu
Maura Madou
Irina Privorotskaya Gaurav Sharma
Jon Maffie
Seema Pursnani
Varun Sharma
Rena Malik
John Quick
Peter Shue
Brijesh Malkani
Sergio Quijano
Yelena Shusterman
Nate Margolis
Katharine Raisler
Jeff Shyu
Tracy Marien
Satya Rao
Jessica Singer
Jennifer Louis-Jacques Sherine Patterson
Jennifer Setlur
Katrina Lust
Alan Pinyavat
Colleen Lynch
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
19
Annual Report 2006-2007
Appendix
Student-Raised Finance Statement 2005-2006
E
ducation is central to the
Sources of Funding
NYCFC mission.
It is manifested
Fundraising
$24,478
in
virtually
eve
ry
aspect
South Asian Community Health Grant
10,000
o
f
t
h
e
c
l
i
n
i
c
,
f
r
o
m
t
h
e
NYU SOM Caring for the Community Grant
9,000N Y C F C
administration to the Saturday clinic
sessions.
AMA Reach Grant
5,000
AAMC Caring for the Community Grant
3,000
Laura B. Vogler
Foundation Grant
2,500
Administratively,
a Steering Committee
of seventeen
New York Community
Bank
1,000
second-year NYU medical students manages the
NYU SOM Student Council
6,240
executive operations of the clinic, gaining direct
Total Funding
$61,218
experience not only in how to run an urban
primary care clinic, but also in developing a costExpenses
effective model for free healthcare in New York
Referral Services
$27,500
City.Materials
Additionally,
five fourth-year medical
Volunteer Support
& Training
2,781 students
serve
as
Clinic
Coordinators
to
provide
Telephone Services
927 a stable
liaison
between
the Steering
Patient Education
Materials
& Office
SuppliesCommittee
921 and the
Steering Committee Meeting Expenses
628
Specimen & Materials Transport
412
Miscellaneous
1,549
Total Expenses
$31,620
Most Common Chief Complaint by Category: FY 2005-2006
Psych
(2.4%)
Respiratory
(1.8%)
Allergy/Immuno (4.7%)
Cardiology
(2.1%)
Dermatology (4.9%)
Other (7.5%)
Endocrine (3.5%)
ENT (0.8%)
OB/GYN
(15.8%)
GI (2.7%)
GU/Renal (4.6%)
MSK/Rheum (4.6%)
Health Maintenance
(44.6%)
20
Supporting the Uninsured of New York City
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
Saturday clinic sessions while adding their
Total FY 2005-2006 Patient Population by Residence
clinical experience to the management team.
Bronx
(3.5%)
During Saturday clinic sessions,
at all
Statenvolunteers
points in their medical training
are involved in all
Island
(0.5%)
aspects of patient care. A team-oriented approach
to care is emphasized as student and physician
Queens
volunteers teach and learn
from each other. Medical
(21.3%)
teams composed of one
preclinical and one clinical
medical student gain experience in seeing patients
by taking medical histories, conducting physical
exams, and generating a differential diagnosis.
The student volunteers then present the patient’s
case to the physician, and together they develop
an assessment and plan to provide the best care
possible for each patient.
Brooklyn
(37.1%)
Yet the experience
that volunteers gain at the
Manhattan
NYCFC extends far(37.6%)
beyond the provision of care.
From a public health perspective, students learn
about the challenges and health disparities facing
the millions of uninsured, and see firsthand the
importance of making a difference one patient at a
Patient Age:
Fiscalto
Year
2005-2006
time. Working with and providing
access
care
for
some of New York’s most underserved populations,
120
the volunteer management and clinical teams learn
to confront 100
and overcome the many barriers to
healthcare access.
80
The NYCFC has
developed a uniquely comprehensive
60
set of free services available to all patients, ensuring
that access to40quality healthcare will not be dictated
by personal
financial status. This model of free
Number
20 of Patients
comprehensive
care also allows physicians and
students to practice
medicine in its purest form,
0
where only the patient's
is
considered
Under 18 wellbeing
18-25
26-35
36-45 in 46-55
developing the best treatment plan. Patient Age (Years)
56-65
66+
Volunteering with the NYCFC is integral to the
NYU SOM experience as the majority of students
serve in some capacity at the clinic over their four
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
21
Looking Ahead: 2008 and Beyond
To Better Meet
the
Needs
T
he New York City Free Clinic continually
strives to improve its services, expand
its patient base, and reach out to
the underserved communities of New York
City. Recently, the NYCFC has improved
its Saturday clinic by increasing its patient
capacity, by expanding the number of clinical
teams and hours, and by collaborating with
the Institute for Family Health to provide fulltime patient service representatives available
by phone to our patients.
of the
Uninsured
In addition to the Saturday clinic, the
NYCFC has worked to provide services to
underserved populations in two new exciting
ways. The first is through community outreach
programs. A team of student volunteers led
by a dedicated physician utilize public health
and prevention strategies to screen for
cardiovascular disease and risk factors while
offering education to patients throughout the
greater New York City area.
The second way in which the NYCFC has
expanded its services is through the inception
of a Women’s Health
Clinic, opening in
February 2008. This
newest addition
to the NYCFC will
provide much
n eed e d w o m e n ’s
health services as
there is a substantial
shortage in the range
and availability of
women’s healthcare
to the uninsured
and underserved in
NYC.
NYCFC Steering Committee
Top Row (Left to Right): Radhika Bauer, Gilda Boroumand,
Rushi Parikh, Marc Ialenti, Elizabeth Gurney, Nathaniel Smilowitz,
Pragati Tandon, Robert Baumgartner, Jeremy Beitler
Middle Row: Mansi Shah, Brad Kligman, Rena Malik,
Maura Madou, Jolyn Taylor, Emily Stamell, Sara Rostanski
Bottom Row: Sajan Patel, Jonathan Baghdadi, Rose O'Rourke
Not pictured: Pritha Gupta, Allison Markowsky
22
Supporting the Uninsured of New York City
New
York City
New York University School of Medicine in Partnership with the Institute for Family Health
Credits
The successes of the NYCFC are due entirely to
the strong commitment of its volunteer base,
management, and organizational partners
to providing quality and comprehensive
healthcare services to the uninsured while
educating the next generation of healthcare
professionals. With the continued devotion of
current collaborators and the never-ending
search for new operational and financial
partners, the NYCFC will continue growing
and enhancing services to better serve the
needs of New York’s uninsured.
References
From "Healthcare Crisis" Page 6, by Jessica Watterson
(1) “Health Care Access Among Adults in New York City.” New York
City Department of Health and Mental Hygiene. May 2007. http://
www.nyc.gov/html/doh/downloads/pdf/ hca/hca-nyc-adults.pdf
(2)“Premium Rates For HMO Standard Individual Health Plans by
County.” New York State Department of Insurance. August 2007.
http://www.ins.state.ny.us/ihmoindx.htm
(3)“Health Disparities in New York City. New York City Department
of Health and Mental Hygiene. 2004. http://www.nyc.gov/html/
doh/downloads/pdf/epi/disparities-2004.pdf
(4)“Increases in Health Insurance Premiums Compared With Other
Indicators, 1988-2006.” The Commonwealth Fund. 2006. http://
www.commonwealthfund.org/chartcartcharts/chartcartcharts_
show.htm?doc_id=472720
(5)New York State Department of Health. http://www.health.state.
ny.us/nysdoh/fhplus/who_can_join.htm/. Maximum gross annual
income $25,755 for family size three, two parents and one child,
effective January 1, 2007.
(6)“Under 65: ER Use - Comparisons with US Insured and
Uninsured, 2004.” The Commonwealth Fund. http://www.
commonwealthfund.org/chartcartcharts/chartcartcharts_show.
htm?doc_id=482809
(7) See Reference 1.
To request a copy of the Free Clinic
Annual Report, please email:
[email protected]
or visit us online at:
www.med.nyu.edu/nycfreeclinic/
Layout & Design:
Cristian Valenzuela- MS I
Bridging the Gap: The New York
Figures/
CityData
FreePresentation:
Clinic Annual Report 2004-2005
reflects clinic services and patient data
Jonathan Berliner- MS I
David Gutman- MS I
Cristian Valenzuela- MSI
Authors:
Maura RZ Madou- MS II
Jolyn S Taylor- MS II
Jeremy R Beitler- MS IV
Maya Barghash- MS IV
Karina L Vivar- MS I
Gilda Boroumand- MS II
Jessica Watterson- Undergraduate Intern
Acknowledgements:
Patient database creation and
management:
Pragati Tandon- MSII
Data Entry:The entire 2007-2008 steering
committee and all of the undergraduate clinic
volunteers, as well as invaluable help from:
Kristin Ow Chapman, Kristina Dvorakovskaya
Niushen Zhang, Irene Isabel Lim, Karina L Vivar,
Jessica Watterson, Swathi Tadoori
Additional Content Input: Mansi Shah, Marc
Ialenti, Rena Malik, Rushi Parikh, Addie Peretz
Editing: Maura Madou, Jolyn Taylor, Irene Isabel
Lim, Karina L Vivar, Cristian Valenzuela, Joseph
Oppedisano, Maxine Golub
New York City Free Clinic
16 East 16th St
New York, NY 10003
(917) 544-0735
www.med.nyu.edu/nycfreeclinic/
[email protected]
Copyright ©
2008 New
York
City Annual
Free Clinic
Bridging
the
Gap:
Re-
23
New York City Free Clinic
16 East 16th St.
New York, NY 10003
(917) 544-0735
www.med.nyu.edu/nycfreeclinic/