Every week, dozens of moms and their kids come into one of Dr. Richard Brown's Detroit offices, not primarily to get medical attention, but to get food.
Nutritional advice and vouchers for food and baby formula dispensed at mobile clinics in doctors' offices like Brown's are free to poor mothers and their children under a federal program called Women, Infants and Children (WIC). While most WIC clinics are freestanding, these clinics bring mothers into a medical setting to get more than just vouchers and counseling.
By combining public programs for nutrition and health care, organizers of the small program hope they can encourage those collecting their vouchers also to see a doctor with the goal of getting low-income mothers and children healthier.
"(The clinics) get some of the kids that we would never see, even though, believe it or not, they're assigned to us by the HMO (health maintenance organization). They're our patients but they still don't come in," Brown said in a telephone interview.
The clinics are organized by OmniCare, an HMO contracted by the state of Michigan to manage benefits for Medicaid recipients in the Detroit area. So far, some 1,000 patients are signed up in the company's Medicaid plan.
OmniCare is trying to take advantage of the fact that people who qualify for WIC are also eligible for Medicaid, the state-federal health insurance program for the poor. So the company runs mobile WIC clinics in a dozen doctor's offices for the City of Detroit, and they are open to all of the city's 35,000 WIC recipients.
There are plenty of other clinics besides OmniCare's to choose from, but they're not in doctors' offices. The city runs 10 WIC clinics on its own, including some that also handle Food Stamps, a separate federal program to help poor people (not just mothers and children) get food.
Brown, the Detroit doctor, said one benefit of OmniCare's approach is that it makes it more likely that the young children who come into doctors' offices will get immunized early. Often, parents wait until their children go to school - where immunizations are required - before getting them vaccinated, he said.
In fact, OmniCare officials said the approach has helped its patients get screened for lead blood levels more often and see their doctors more regularly since the clinics were started in spring 2006.
"Most times with the Medicaid members, the hardest thing is reaching out and touching them, because you have bad phone numbers and bad address information. Anytime we have a point of contact with one of our Medicaid members, we want to maximize the outreach," said Beverly Allen, OmniCare's chief executive officer.
Normally, WIC nutrition specialists ask their clients whether they've been seeing a doctor or getting tests done. But the specialists in this program can know whether OmniCare enrollees have, for example, seen their family doctor or obstetrician/gynecologist, because they can pull up that information on their computers, said Jessica Gardon Rose, director of quality improvement for OmniCare.
The clinics rotate among 12 different sites chosen for their ability to handle an influx of patients and their location. OmniCare officials said they selected sites that were spread throughout Detroit and are close to bus routes.
Some sites hold the three-hour sessions twice a week; others play host as little as once a month. OmniCare pays doctors a small fee for laboratory services for WIC clients, but they receive no rent. Allen, OmniCare's CEO, said the physicians are essentially performing a "community service" by offering their facilities.
Nationally, the WIC program delivers food, nutritional information and medical screening to 8 million poor mothers, expectant mothers and their young kids (under 5), including 45 percent of infants born in the United States.
To qualify, recipients must go through an initial screening and be deemed to be in "nutritional need." Depending on their situation, they must return to get their vouchers as frequently as once a month but at least once every three months. Recipients are eligible for food vouchers for baby formula, milk, juice, cheese, eggs, tuna, cereal, cereal, peanut butter and beans.
The City of Detroit, like many WIC agencies, recruits applicants through visits to hospital delivery rooms and the offices of obstetricians and gynecologists, said Indira Arya, the interim director of Detroit's WIC program.
The city's WIC recipients can get just their food vouchers through OmniCare clinics, but health plan officials hope to attract new patients who like the convenience of getting their food and medical care at the same time.