By Michael Kesti and Hilda S. Mitrani

If you or someone in your company lacks health insurance, medical care is still available outside of an emergency room or urgent care center. Low-cost, high quality medical treatment exists throughout Greater Miami. Two options are clinics run by the Jackson Health System and the federally qualified health care centers known as Community Health Centers.

In all of these, patients can see a physician; receive many laboratory exams and prescription drugs. Patients are charged on a sliding fee scale according to income and they pay rates that are considerably lower than if seen by a private physician, in an urgent care center or in a hospital ER. Sometimes, the treatment, diagnostic tests and medicines are all free of cost. Several federally qualified health centers and community clinics have locations throughout Miami-Dade, and the ones below are members of the Chamber:

Miami Beach Community Health Center, a federally qualified community health center, was established in 1977. Our mission is “To provide quality, affordable health care and support services to the Miami Beach community and all of Miami-Dade County.” Our target population is the uninsured, underinsured, indigent, and insured residents of Miami Beach and Miami-Dade County. Board certified specialties include family medicine, pediatrics, obstetrics, gynecology, endocrinology, internal medicine, geriatrics, and behavioral health. The Miami Beach Community Health Center operates five centers in South Beach, North Beach, North Miami, Little Haiti, and a school-based health center at Miami Beach Senior High School for students only. For more information, visit www.miamibeachhealth.org or call 305-538-8835.

Community Health of South Florida, Inc. (CHI) is a nationally recognized and Joint Commission-accredited provider of affordable health care services to South Miami-Dade County and Monroe County. CHI operates seven (7) Health Centers and twenty seven (27) school-based centers offering primary care and behavioral health care services to those with and without insurance. CHI offers family medicine, OB/GYN, dental care, pharmacy, laboratory, radiology, pediatrics. In addition, CHI offers CareNet, a network of over 200 healthcare providers throughout South Florida that provides care at discounted rates.

Jackson Health System clinics are located from South Miami to northeast Miami-Dade. Jackson patients must bring proof of Miami-Dade County residency, photo ID, and proof of income to schedule an appointment and/or in order to qualify for health benefits. The Jackson clinics provide high quality, extensive and convenient healthcare services and the staff will assist patients in applying for government health benefits. For more information and to make an appointment, visit www.jhsmiami.org or call (305) 585-1111. You can also contact Patient Relations at (305) 585-7341.

The Jessie Trice Community Health Center, Inc. (JTCHC) is a non-profit Federally Qualified Health Center that has been serving the uninsured and underinsured in Dade County since 1967. JTCHC owns and operates 6 primary care sites, 20 school-based centers, and residential/outpatient treatment facilities for substance abuse. A multicultural, multilingual and multidisciplinary staff of 250 provides services to a very diverse population of 28,000 patients who make more than 111,000 visits annually. JTCHC’s medical staff includes 27 physicians, dentists, and nurse practitioners (80% Board Certified). Services include Family Practice, Internal Medicine, OB/GYN, Pediatrics, Dental, Podiatry, Radiology, Lab, Vision, Mental Health, Transportation, and much more. To schedule an appointment, please contact us at (305) 637-6400

Borinquen Health Care Center Inc. has primary care clinics in the Miami Design District and in the West Dade/Sweetwater area. Behavioral health is provided at a separate Design District location. The primary care centers serve the uninsured and underinsured by providing family oriented, high quality affordable adult, pediatric, and OB/GYN services. Mothers deliver at North Shore Medical Center and Jackson Memorial Hospitals. At the main site, HIV/AIDS, dental, optometry, laboratory, radiology and an on-site pharmacy are also offered. For more information, visit www.borinquenhealth.org or call (305) 576-6611.

Camillus Health Concern (CHC) provides a comprehensive and multidisciplinary range of primary, preventative and supplemental health services for persons who are homeless at 5 sites in Miami-Dade. Services include primary care, mental health counseling and treatment, oral health, podiatry, dermatology, HIV/AIDS prevention and education, and case management/entitlement services. Additional services are provided in a seamless continuum of care through CHC’s sister organization, Camillus House, and include emergency, transitional, & permanent housing, substance abuse treatment, and social services such as food, clothing, showers, and rent assistance. For more information, please call 305-577-4840, ext. 116 or visit http://www.camillushouse.org/camillus_programs/comprehensive_healing/.

What is a medical home and where are they located in Greater Miami? Everyone should have a medical home, whether it's a primary care physician or a clinic that you always go to first. A medical home is defined as a place to get accessible, continuous and family-centered care.

Patients benefit from having an established medical home because they are continuously treated by one team. Studies have proven that patients have improved odds of being in good health, and that they have better management of chronic conditions such as diabetes, asthma, or heart disease and reduce the risk of new medical problems. This ultimately leads to fewer hospitalizations and fewer visits to the ER. (You can learn more on the website of the National Association of Community Health Centers, www.nachc.org.)

Click here for information provided in collaboration with the Miami-Dade Community Health Report Card, you can review a comprehensive list of approximately 40 convenient, accessible and affordable primary care centers in Miami-Dade County.

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By Hilda S. Mitrani

Five Wishes is a living will that helps you express how you want to be treated if you are seriously ill and unable to speak for yourself. Although written in plain language, Five Wishes is now a valid legal document in Florida and 39 other states. Created by Aging With Dignity, an international organization, it addresses all of a person's needs: medical, personal, emotional and spiritual. It is available in multiple languages and in bilingual editions.

More than twelve million copies of Five Wishes are circulating throughout the United States and more than 15,000 organizations are distributing it. Many employers are providing Five Wishes to their employees to help them plan for themselves and have those delicate discussions with their aging parents.

Chamber members can take advantage of a special offer to buy their own personal copy of Five Wishes. Visit www.agingwithdignity.org/5wishes.html and use the code GMCC.

Thank you to Mark Cohen at VITAS for assistance with this project.

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Effective caregiving is physically challenging and emotional under the best of circumstance. Research has found that caring for an aging parent is stressful and may lead to increasing levels of anxiety, depression, chronic pain other symptoms associated with the challenge of providing care for a prolonged period of time to some suffering from a chronic health problem.

Caregivers could improve their quality of life and the quality of life of their loved ones by finding constructive ways to manage the symptoms associated with caregiving.

Following are some resources that can help caregivers.

The Aging Resource Center of the Alliance for Aging offers information and referral for services available to older adults and their caregivers. Respite services may become the caregiver “life-line” and enable the caregiver with time to take care of personal needs. The Aging Resource Center can be accessed by calling: 305-670-4357 (HELP) or by visiting http://www.allianceforaging.org/arc.html

The Healthy Aging Regional Collaborative (HARC) of South Florida, an initiative of Health Foundation of South Florida, is a network of aging services providers, health care organizations and local cities. HARC offers caregivers two proven workshops: “Living Healthy with Chronic Health Problems” and “Tomando Control de su Salud.” The workshops consist of six weekly sessions developed at Stanford University. Living Healthy Workshops have been offered at hundreds of locations throughout the United States. It helps participants with ongoing health conditions such as arthritis, diabetes, high blood pressure, anxiety, heart disease, anxiety and others to:

• Find better ways of dealing with pain and fatigue
• Discover easy exercises to help improve or maintain strength and energy
• Learn the appropriate use of medications
• Improve nutrition
• Talk effectively with family, friends and health professionals
• Understand new treatment choices
• Feel better about life

For more information on Living Healthy or Tomando Control de su Salud workshops visit: www.healthyagingsf.org.