Health centers back Menino against CVS clinics

Community health center leaders are just as opposed to CVS stores opening mini-clinics as Mayor Thomas Menino, but that isn't the end of it. Regional leaders are exploring opening their own versions.

State regulators last week approved rules establishing "limited service clinics," which they said would allow for quick, convenient care for minor ailments.

Menino blasted the decision, saying in a statement: "People need continuous care, and this type of for-profit facility is ignoring the standards and measures needed for quality care."

The regulations apply to any retail company or non-profit, including CVS Corp., which plans to open some 30 clinics in Greater Boston in the next year.

While community health centers raised concerns about setting up retail clinics, echoing fears that the new clinics would lead to a greater fracturing of primary care and patient records, the centers are poring over the regulations to see where they could fit in.

"The regulations that extend clinic licensure certainly would have an attraction to community health centers" who are interested in expanding are to their patients, according to James Hunt Jr., president and CEO of the Mass League of Community Health Centers. The league is an association of 185 community health center sites, serving 700,000 state residents a year.

Community centers would take a different tack than the for-profit clinics, emphasizing a continuity of care for the patients, he said.

"If in fact we were to look at these, and we certainly are, we'd look at them from the perspective of how we can best create the connectivity...rather than retail," he said.

Hunt said he wouldn't rule out health centers also running retail clinics in a for profit manner, but with the aim of funneling back funds to the non-profit.

The health centers could also team up with other retailers or organizations, he said.

The number of limited service clinics that could crop up in Dorchester is unclear.

MinuteClinic, which is a subsidiary of CVS Corp., had planned to start in Weymouth before expanding to Boston, and eventually build over 100 statewide.

Visits tend to take about 15 minutes and cost about $59, and the stores provide flu shots and other vaccines, treatment for allergies, bronchitis, and sinus, eye and skin infections.

Local health centers however, see no silver lining on the limited service clinic cloud.

Ed Grimes, head of the Uphams Corner Health Center, pointed to the shortage of nurse practitioners, who under the rules would staff the limited service clinics, as the main factor in opposing the clinics.

"Once CVS does this, then you will have Target, Wal-Mart, perhaps the supermarket chains doing the same things," he said. "They'll watch, and if it's good business, they'll be doing it."

The arrival of the clinics could launch a salary war, which would be detrimental to primary caregivers, he said.

His own health center is trying to fill three nurse practitioner positions. "Once this enterprise gets underway, it's going to be all that more difficult and it's going to have a potentially negative impact on the health and wellbeing of a significant number of community residents," he said.

Bill Walczak, CEO of the Codman Square Health Center, said his center has already had an urgent care center for 10 years. The center has x-ray and lab services, he said.

The facilities that state regulators approved are "extremely limited" he said, and could lead to misdiagnoses.

"It muddies the water of the health care system that's already pretty damn muddy," he said.

If there was a community need that wasn't being met, and we had the capacity, maybe," he added. "The cost of doing it the right way probably would only make sense if it were in a place that was far from other care centers."

Walczak said he and the other clinics are supporting Menino's efforts to exclude the pharmacy clinics through regulations.

Menino has called on the Boston Public Health Commission to explore its authority in limiting the sale of tobacco products in retail stores with the clinics. Menino and others argue that the clinics shouldn't be in the same area where harmful tobacco products are being sold.

The commission's legal counsel will report back as soon as possible, possibly Feb. 14 at the earliest, according to a commission spokeswoman.