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Need a clinic? Just step into the elevator

Brenda Williams sometimes nags her neighbors.

But the energetic 58-year-old insists it’s for their health.

About 7 every morning, Williams makes her rounds at Morris H. Blum Senior Apartments in Annapolis, gathering fellow residents for their daily walk. She’ll bang on doors if she has to, picking up stragglers and recruiting more members for the walking club she started about four months ago with help from outreach workers from Anne Arundel Health System.

“I wanted to do something that we could all benefit from, healthwise,” Williams said. “I’m getting people every day to step up to the plate. We weigh in every Friday … I’ve already lost 17 pounds.”

Local officials hope to increase that kind of grassroots, results-driven activity with the opening of the Anne Arundel Medical Center Community Clinic, a new primary care center in the Morris Blum building, a public housing site for elderly or disabled individuals. The state helped with financing.

Anne Arundel Medical CenterOfficials held a lively, well-attended ribbon-cutting ceremony on Thursday, although the clinic, which employs one physician plus several nurses and staffers, started seeing patients in mid-October.

The opening culminates years of planning and months of renovating by a coalition of local groups that joined forces to apply for funding through the state’s Health Enterprise Zone program, which injects money into areas with unmet health needs or stark health disparities between different populations or geographic areas.

In January, Annapolis was recognized as one of five HEZs across Maryland, and the Annapolis Community Health Partnership was awarded a total of $800,000 over four years to address the area’s most pressing issues: soaring numbers of emergency room visits and hospitalizations, as well as widespread chronic disease.

Anne Arundel Medical Center worked with the Housing Authority of the City of Annapolis, which owns Morris Blum, and other local agencies to convert the space into the clinic. They put the first $200,000 in HEZ money toward building out three exam rooms, adding a waiting area, installing equipment and wiring up all the required technology.

AAMC chipped in $185,000 to cover the remaining renovation costs, officials said. Victoria Bayless, president and CEO of AAMC, estimated the clinic’s annual operating costs will likely be about $300,000.

The new clinic won’t just serve Morris Blum residents; officials are targeting all uninsured or underinsured people living in the Annapolis Health Enterprise Zone, as well as residents of other public housing units nearby. It could potentially serve about 3,000 patients, which is “a pretty full panel for one primary care physician,” said Patricia Czapp, chair of clinical integration at AAMC, who helped organize the project.

A typical HEZ resident tends to seek treatment from emergency departments even for minor issues, which is a very expensive and ineffective long-term health care strategy, Czapp said.

From November 2011 to November 2012, Morris Blum residents made 220 medically related 911 calls. In six months alone, 73 Morris Blum residents experienced 175 emergency room visits, with 38 of those resulting in admissions. One resident made 50 emergency calls.

“There’s been such a high number of 911 calls from that one address, we wanted to demonstrate that having a medical practice in the building could affect the number of calls, because rather than calling 911, [residents] could hit the elevator button and go see the provider on-site,” Czapp said.

Within the clinic’s first year, officials hope residents of Morris Blum will experience a 30 percent reduction in medical 911 calls, emergency room visits and hospital readmissions.

Each of Maryland’s five HEZs are managed by a local coalition of nonprofits and government agencies that receive a range of financial incentives, including grant funding, to address the health issues in their area. The state budgeted $4 million over four years for the program, which is administered by the Community Health Resources Commission and the Department of Health and Mental Hygiene.

The other four HEZs are in West Baltimore, Capitol Heights in Prince George’s County, Greater Lexington Park in St. Mary’s County and Dorchester and Caroline counties on the Eastern Shore.

“People say, ‘Why is the City of Annapolis applying for HEZ status — what poverty do they possibly have?’” Czapp said. “But we have pockets of great poverty amidst great wealth. That’s why we hope this little practice plopped down in the middle of it can effect great change for that community.”

But opening a new community clinic isn’t without challenges, several people said.

Diana Greenbach, a case manager with the county’s Department of Aging who works with Morris Blum residents, said for some people, the transition to a new routine for getting medical care might be bumpy.

“Many of these people are very connected to their current doctors, so I think it’ll take a little while” for them to warm up to a new physician and start using new primary care services, Greenbach said.