Crown Medical Support Services Organization

Crown Medical Support Services (CMSS) was established in 2007 as a nonprofit entity to provide medical services and educational outreach to the uninsured, and underinsured, who cannot pay for those services in Crown Medical Center's mainstream clinics.

Since its inception in 2005, the Crown Medical Center clinics and CMSS have offered medical services, preventive health education, and health screening services to over 10,000 Minnesotans.

Philosophy of Crown Medical Support Services

Crown Medical's state-of-the-art facilities and highly trained, compassionate staff are equipped to provide treatment in a professional, caring and respectful manner. CMSS staff members take a proactive approach and believe strongly in the value of healthcare screening and preventative healthcare education.   We take a collaborative approach to providing training and continuing education to healthcare students, medical interns, community health workers, and other medical professionals.

Crown Medical has provided services to a large number of African immigrants, African Americans, Hispanics, and Southeast Asians living in the Twin Cities Metropolis. Crown Medical Center clinics and CMSS strive to reduce barriers to accessing quality healthcare by providing culturally sensitive and linguistically appropriate medical and preventive health education services to all patients. In this way, we build relationships that promote health in individuals, communities of color, and the general public.

Problem, Opportunities, Challenges, Needs

An August 2010 report by the Wilder Foundation entitled, "A New Age of Immigrants" advised, "Immigration in Minnesota is an important fact to be reckoned with. Our state is playing host to many who have arrived from strife torn countries, and to others who have come seeking opportunity or family connections. During the 1990s, Minnesota's foreign-born population increased by over 130% compared to a 57% nationwide increase over the same period. Between 2000 and 2007, it increased another 33% in Minnesota, compared to 22% nationwide. In 2008, 6.5 percent of Minnesota's total population was foreign born."

A designated refugee settlement area, Minnesota has an unusually large refugee population. In recent years, one in five of Minnesota's new immigrants has been a refugee or asylee fleeing persecution in their homeland. Understandably, the majority of these immigrants or refugees from war torn countries  have significant psychological problems. Crown Medical's mental health workers have offered mental health counseling to these individuals. The goal is to determine and encourage healthy coping skills, reduce anxiety that can impair mental, physical, and emotional wellbeing, and to identify strengths that build individual and family resiliency.

Minnesota has the largest community of Southeast Asians in the United States, dating back to the Vietnam War era. Minnesota also has the second largest population of East Africans in the nation.

Among immigrant Africans, Somalis are the fastest growing group in the Twin Cities with the population of about 250, 000.

In Minnesota, 17% of immigrant families live in poverty; this is nearly three times the poverty rate among native-born families (American Community Survey, 2008 data). Immigrant families living in Minnesota are three times more likely to be poor than native-born families. The majority of Crown Medical Center's clients are Africans and African Americans, and most of them are placed below 275% of federal poverty level.

Incidence of diabetes and high blood pressure among these immigrants and African Americans is quite high in Minnesota. More minorities suffer from this disease than any other racial groups. The mortality rate is also higher for people of color. Disease is also more likely to develop at a younger age among peoples of African decent. Compared to Caucasians, diabetes and high blood pressure in people of color develop earlier in life. According to a report released (2005) by the National Heart, Lung and Blood Institute, people of African decent in the US have an 80 percent higher rate of death from stroke, a 50 percent higher rate of death from heart disease, and a 320 percent greater rate of diabetes and high blood pressure related end-stage renal disease than the general population. About 65 million American adults have hypertension and more than 40% are African Americans.

Crown Medical's practitioners have seen an upsurge in the number of African immigrants diagnosed with these diseases. Because of dramatic change in diet and other lifestyles following immigration to the United States, incidence of diabetes and hypertension has reached an alarming proportion in the African population. Based on Crown Medical's recent clinic findings, about 25% of Somali adults who utilize the clinics primary care services have diabetes and more than this number have hypertension. If untreated, high blood pressure and diabetes could lead to coronary artery disease, heart attack, congestive heart failure, kidney damage and death. The mortality and morbidity rates are so high because people who survive a first heart attack have a 1.5 to 15 times higher chance of illness or death than the general population. The social and economic burdens on the state of Minnesota and on individuals due to undiagnosed and untreated hypertension and diabetes are very high. CMSS strongly believes that morbidity and mortality rates due to these two diseases can be reduced through simple preventative health education measures.

Media Outreach and Expertise

CMSS provides health education outreach services through the media and through scheduled classes, and this is the key to containing the morbidity and mortality associated with most diseases. Crown Medical Support Services staff members are regular guests of the McFarlane radio show in Minneapolis (KFA1 90.3) every first Tuesday of the month where robust conversations pertaining to healthcare disparities are discussed alongside with solutions to bridging the gaps. Crown Medical also publishes articles monthly on preventive health topics in several key Twin Cities newspapers.

Crown Medical Center has seven providers including 3 Board certified MDs, 1 Certified Physician Assistant, 1 Nurse Practitioner and 2 Licensed Social Workers. Dr Joyce Onyekaba, is a Board certified internist with over 21 years of active practice experience. In the state of Minnesota, Crown Medical Centers are among the only cultural specific clinics that predominantly carter to people of color.

Crown Medical and CMSS see an average of 35 patients daily and its total patient population on record exceeds about ten thousand. Because of the multicultural backgrounds of those Crown Medical serves, many times it is necessary to have interpreters explain symptoms and ailments. Interpreters also help clients to understand the exam and treatment procedures and options. In its laboratories, Crown Medical is able to perform many tests to help determine the condition of the patients.  With many of patients coming from Somalia, Mexico and Latin America, there is a high incidence of HIV, hepatitis, and other communicable diseases.

USCIS Civil Surgeon Designation

Applicants for adjustment of status are required to have a specific medical examination, which must be conducted by a Civil Surgeon who has been designated by the United States Citizenship and Immigration Services.

Crown Medical’s Civil Surgeon, mental health workers, and professional staff members provide services for individuals and families to assure a positive experience in completing required medical evaluation processes for immigration purposes. In addition to a complete Civil Surgeon examination and vaccinations, Crown Medical Centers assist with proper INS forms completion, medical waivers, emergency medical assistance, and also offer a travel clinic that provides complete immunization and consultative service for international travelers. Crown Medical works with clients to insure that all immigration-related forms are completed timely and properly, and that examinations are thorough and concise.

Relationship to Other Organizations

In order to reach the gamut of African immigrants, Crown Medical has collaborated and worked extensively with key African community organizations in developing culturally sensitive preventive health education materials.  These organizations include the Pan African Community Organization (East and Southern African organization), Hope International and Social Services Organization (West African based) and Sub Saharan African Youth and Family Services in Minnesota (East and Northern African focus).

Because no single organization can reach the entire African population, CMSS involves these organizations collaboratively in patient referral and delivery of linguistically appropriate health education classes on many key topics including, but not limited to, diabetes, hypertension, obesity and weight management, heart disease, smoking cessation, HIV and Aids, and family planning.

In recent years, Crown Medical and CMSS have invited several distinguished visitors to visit Crown Medical. These include the former Minnesota Health Commissioner Diane Manderanch; the State Director for Primary Medical Care Services, Mr. Mark Schoenbaum, Minnesota State Director of Minority and Multicultural Health, Mr. Mitchell Davis, and the regional director, Ms. Mildred Hunter, and the Director for Minority and Multicultural health, Mr. Jose Gonzalez. They were most impressed with the scope of Crown Medical Center and CMSS services.

Crown Medical Support Services has a long­standing relationship with many community leaders and people from the underserved population. In addition CMSS has a learning and clinical partnership program with Globe College in Minneapolis, Kaplan University, the University Of Minnesota Medical School, High Tech Academy Medical Assistant Program, Minneapolis Public School Special District #1, Minneapolis Park and Recreation Services and Bethel College school of Nursing. The clinical externship programs afford nursing and medical students the opportunity to perform 15 weeks of work at Crown Medical, working on health disparities and health improvement projects.

Recognition and Awards

In the state of Minnesota, Crown Medical ranks in the top bracket of cultural specific centers that cater to the health needs of people of color, especially African immigrants.

In May of 2011, Crown Medical Center was recognized at UCare’s “Salute to Excellence” awards dinner honoring the top performers in the 2009 Pay for Performance program as a clinic demonstrating outstanding performance along several key Medicare and Medicaid health measures.