Diverse partnership gives birth to clinic Nurses to run low-cost health center

A ribbon-cutting at 920 Washington Blvd. yesterday celebrated the completion of a year's hard work to turn two derelict Baltimore rowhouses into a gleaming new low-cost health-care center -- a national model for clinics run by nurses instead of physicians.

The Open Gates Nurse-Managed Health Center, an outgrowth of the Paul's Place soup kitchen on the southwest edge of downtown, is the result of an innovative partnership that crosses religious, cultural, professional, economic and city-county lines.


The partners include Episcopal clergy and lay people, members of other religious denominations, students and faculty members from the University of Maryland School of Nursing, representatives of private foundations and the federal government, community leaders and merchants from Southwest Baltimore's Pigtown-Washington Village area, and businessmen from Baltimore County's Green Spring and Worthington valleys.

But the point man, the clinic's benefactors agree, is its dynamo of a director, Laird Lorenz.


The 46-year-old, Chicago-born Marine veteran of Vietnam is a psychiatric social worker and community organizer with a quarter-century of experience in a variety of programs to improve urban conditions. Mr. Lorenz is -- in his own words -- "a hustler."

"Laird has been invaluable to us," said the Rev. Philip B. Roulette, rector of St. John's Episcopal Church in Glyndon, who is president of the Open Gates board.

"Laird Lorenz is impressive," said E. Phillips Hathaway of Owings lTC Mills, who arranged a $250,000 donation from Baltimore's Middendorf Foundation. "We could not have done this without him."

The three-story clinic, redolent yesterday of fresh plaster, paint and carpeting, contains six examining rooms, two laboratories, a classroom and a conference room, along with bathrooms, a kitchen, offices, storage areas and a waiting room. A blue awning bearing the clinic's name shades the entrance.

The clinic -- which Mr. Lorenz said was "designed by the nurses to be user-friendly" -- will operate three days a week beginning next Monday.

Until a year ago, Mr. Lorenz was director of Paul's Place, the busy soup kitchen at nearby St. Paul the Apostle Episcopal Church on Washington Boulevard. He said a one-room clinic operated there since 1986 by instructors and students of the University of Maryland School of Nursing inspired Open Gates.

"We opened the clinic at Paul's Place to serve the homeless of Southwest Baltimore," Mr. Lorenz said. "Over the past few years, we've seen a large number of area residents who aren't homeless but who don't qualify for federal medical assistance and can't afford private insurance premiums. Open Gates will fill that need."

Fees will be on a sliding scale depending on ability to pay, with a minimum of about $5 per visit. "Everybody will be asked to contribute something," Mr. Lorenz said, "but no one who can't pay will be turned away."


The clinic's facilities are designed to handle pediatric, geriatric and women's needs separately, and the prevention of illness and health education will be emphasized. "We have a lot of alcohol and drug abuse and teen-age pregnancy in this area," Mr. Lorenz said.

Father Roulette called the project "the church at its very best -- individual Christians working together as volunteers to make it happen."

On his board are lay people from five Episcopal parishes -- Sherwood in Cockeysville, St. Thomas' in Garrison, Old St. Paul's and the Church of the Redeemer in Baltimore, and St. John's in Glyndon.

The Rev. Tomlin Crowder, rector of St. Paul the Apostle; Rebecca Eddins, the director of its soup kitchen; Dr. William Fritz, a physician; and two UM School of Nursing faculty members, Mildred S. Kreider and Maren Mayhew, are also on the board.

Dr. Kreider, who chairs the school's Department of Psychiatric, Community Health and Adult Primary Care Nursing, said that about 40 community-based health-care centers in the United States have ties to nursing schools and are managed by nurses but that Open Gates may be the first to be founded in a partnership with church groups.

She said UM physicians will provide consultations and accept referrals from Open Gates under an arrangement with Dr. Herbert L. Muncie Jr., chairman of the medical school's Department of Family Medicine.


Mr. Lorenz said the board paid the federal government $20,000 for the two connected buildings at 920 and 922 Washington Blvd. and spent $145,000 rehabilitating them.

"They had been a sub shop and a cleaner's but were vacant and decaying for almost eight years," he said, adding that a title search turned up some appropriate Baltimore history: There was once a home for abandoned children on the site.

"There were lots of structural problems," Mr. Lorenz said, praising Gary Houston and Rick Yaffe, who head the large Landmark Homes development company based in Towson, for helping with the renovations.

"I've basically hustled for everything, for furniture and medical equipment and supplies," Mr. Lorenz said. Contributors that have responded include Bon Secours and UM hospitals and the Salvation Army.

In addition to the $250,000 from the Middendorf Foundation, Father Roulette said, donations include $25,000 from the Merrick Foundation, $15,000 from the William G. Baker Foundation and $20,000 from board members and others.

A U.S. Public Health Service grant of $654,000 over three years will "provide a study of the effects of better access to quality health care for medically underserved people in two census tracts," Dr. Kreider said. "We will follow the people and see how their health improves."


An annual budget of $150,000 to $200,000 is projected for the clinic, Mr. Lorenz said.

Mr. Hathaway and his wife, Barbara, suggested the Open Gates name. "It was what an old place down South that we always admired was called -- a warm, welcoming type of thing -- and the board seized on the name," Mr. Hathaway said.

"I think the name symbolizes the spirit of opening up opportunities, an urban ministry that opens its doors to quality health care," Mr. Lorenz said. "And it's a ministry that serves God. Let's not forget why we're here."