Cataract clinic restoring sight, hope to those in need

Betty Dillard

Since its inception in 1992, Cornerstone Charitable Clinic, a part of the nonprofit organization Cornerstone Assistance Network, has provided quality medical care for thousands of low-income, uninsured patients in Tarrant County. Operating through partnerships with local volunteer physicians, nurses and other health care professionals, the clinic serves patients who need comprehensive non-emergency primary care but cannot afford to pay. In addition to primary care, services include nutrition and health education through fitness training, cooking classes and general health information. Now the clinic has set its sights on the problem of cataract blindness and filling the need for ophthalmic care. Last year, after two years of preparation, Cornerstone Charitable Clinic opened the CAN Cataract Clinic, the only known free cataract facility in the United States. In December, the first two cataract removal procedures were performed by Dr. Glenn Strauss, the clinic’s associate medical director. Cataract surgeries in April restored vision to four more patients. One man had lost his job due to low visual acuity, and the others were at risk of losing their ability to work. Early May two more patients had their sight restored at the free clinic. “There will come a time when we’ll do 10 to 20 cataract surgeries a day,” said Mike Doyle, chief executive officer of Cornerstone Assistance Network. “Our goal is to get all our patients back to work or back to their families. They leave here knowing they can do anything. We give them hope. It’s great to see it all come together for them.” Doyle said officials from Fort Worth-based Alcon, maker of eye care products and a major benefactor of the project, suggested establishing the cataract facility at Cornerstone Charitable Clinic. Although the number of underserved, low-income patients in Tarrant County with significant cataracts is not accurately known, referral sources and local ophthalmologists believe it to be in the thousands, Doyle said. “We hope to provide as many resources to really change the lives of our patients. The cataract clinic is another valuable resource for them,” said Lorene McCoy, director of health services. “Our goal is to build a medical home for them. Cornerstone is about getting people to become independent again and not continuing to be dependent on community resources.” Doyle said several critical requirements had to be met to open the cataract clinic. The clinic uses a system of means testing to determine which patients are most in need financially. Startup costs were reduced by using a small procedure room rather than a full operating theater, standardized basic supplies and equipment donations. Ongoing costs are reduced by using volunteer surgeons and nurses, keeping the focus on uncomplicated cataract surgery, and managing patient volume using referral sources to lower the demand for clinic personnel. One such referral source is the new charitable eye clinic opened on the second floor of First Christian Church in downtown Fort Worth. Staffed by medical students from the University of Houston School of Optometry and the optometry school of the University of the Incarnate Word in San Antonio, the clinic is helping the homeless and others who can’t afford vision care. “Cornerstone was founded with the desire to help others in the community, particularly churches, to do a better job of working with the poor,” said Doyle, who also founded the Tarrant County Homeless Coalition. “It seemed to me that if the congregations were more united in helping the poor, they could have a better income and lifestyle. It was a desire to bring all those churches and nonprofits together into a network where we could share resources and have a greater impact.” Today, the Cornerstone network, with an annual operating budget of $3.6 million, includes 74 churches and 80 nonprofit organizations that share resources and make referrals. Doyle said another critical factor to the Cornerstone Assistance Network opening the cataract clinic was to minimize malpractice risk. Because the cataract clinic is operated by Cornerstone Charitable Clinic, all volunteer health care professionals are covered by the same free malpractice insurance each of the primary care physicians has. All surgeons working at the center must be qualified and registered to work as a Cornerstone Charitable Clinic surgeon, and the clinic must comply with specific rules and regulations. “Building a cataract center exclusively for non-paying patients is not likely to catch on as a good business move,” said Strauss, the associate medical director, “but perhaps using a center like this opens the door for more surgeons to offer their skills in a way that helps them as well as patients.” Strauss added that reducing the malpractice risk and overhead costs addresses some of the basic problems in providing quality health care to low-income patients. McCoy said the cataract clinic is hoping more ophthalmic professionals will volunteer. “The primary-care clinic is the backbone of the cataract clinic,” McCoy said. “Because of the quality of the primary clinic we’re starting to see more and more doctors volunteering.” She said the volunteer base has grown from two to 10 physicians; the clinic now has about 700 volunteers who work in various areas. In addition to the primary and cataract clinics, Cornerstone Assistance Network (CAN) operates a fitness center, Creation Cafe and a retail store. Under the direction of a new chef, the cafe will reopen in June. Both the cafe and the retail store are open to the public and benefit the organization as social enterprises. The store has sold more than $128,000 in merchandise this year and nearly $200,000 worth of clothing, furniture, household goods and supplies have been given away. The cafe also provides job training in food service and hospitality for people leaving incarceration. Two years ago, Doyle helped start the Tarrant County Reentry Coalition to assist people coming out of prison. Other job training programs include truck driving, forklift operation and training in the construction trades through the Cornerstone Housing Development Corp. Through a partnership with the city of Fort Worth, Tarrant County and Bank of America, the housing program has remodeled four Tarrant houses and has a contract to build three new houses in the Polytechnic neighborhood in southeast Fort Worth. CAN also is working on a 32-unit condominium project for homeless families, helping them to become homeowners. “This is a place where people can come for help – jobs, housing, clothing, health care,” said Doyle. The next project is a dental clinic, he added. “What we do as a network is whatever the community needs,” he said.