Mercy Medical Center-Des Moines is helping to fill a void created last summer when Polk County-owned Broadlawns Medical Center severed its 22-year relationship Primary Health Care Inc., putting medical services for thousands of poor and underinsured residents in jeopardy.

“It caught us completely off guard,” Dr. Bery Engebretsen, Primary Health Care’s executive director, said. “We were very much taken aback by the sudden, abrupt change in direction on June 25.”

The action by Broadlawns’ board of trustees immediately sliced Primary Health Care, a non-profit group, in half. The cut is reflected not only in the $4 million budget, down from $8 million, and the 65-person staff, down from 130, but also in the number of patient visits. Primary Health Care reported 63,600 medical and dental patient visits in 2001, but expects only half as many visits as a freestanding health-care provider.

There have been other changes as well. Because it is no longer housed in the county hospital, Primary Health Care’s administrative offices have been moved to a 10,000-square-foot, 12-exam-room clinic 2353 S.E. 14th St. An outreach center has been opened in the Homes of Oakridge community at 979 Oakridge Drive, and shuttle service is provided between the outreach center and larger clinic on Southeast 14th. Primary Health Care holds office hours from 4 to 8 p.m. on weekdays at the Charles Johnson Wellness Center on the Grand View College campus, and operates a clinic in Marshalltown as well. After the Broadlawns decision, Primary Health Care consulted with its federal partners and received the go-ahead to continue with plans to build a 5,000-square-foot, nine-exam-room clinic at East 29th Street and Euclid Avenue.

The new affiliation with Mercy is informal, and it won’t offer the financial and administrative support Primary Health Care received when it was located at Broadlawns. Primary Health Care staff will work with Mercy’s Mayo Family Practice Residency Program, a three-year training program for family-practice physicians.

“We hope that relationship will provide an opportunity for patients Primary Health Care is seeing to also be seen by our residents,” said Annette Bair, Mercy’s vice president in charge of missions and ethics. The collaboration serves the dual purpose of providing Primary Health Care patients with additional physician choices and increasing the number of patients Mercy Mayo residents see.

Additionally, Primary Health Care will help staff the House of Mercy Free Clinic. That will allow the clinic, which operates independently from the House of Mercy residential program for chemically dependent women with young children, to remain open longer hours and serve more patients on the Near North Side.

The new relationship also allows Primary Health Care staff to participate in continuing education programs in social work, nursing and other areas to remain abreast of health-care issues.

Mercy offered to help soon after Broadlawns announced its intention not to renew its service contract with Primary Health Care. “The mission of Primary Health Care has been to serve uninsured and underinsured, and that certainly is something Mercy has always supported,” Bair said. “Their mission is very much like ours, and it’s easy to come together.”

The synergy that existed between Primary Health Care and Broadlawns won’t be easy to duplicate in the new affiliation because Mercy doesn’t have tax dollars to leverage with the provider agency’s federal grants from the Bureau of Primary Health Care and other sources. But Engebretsen said that once he and his staff recovered from the shock of Broadlawns’ decision to severe its ties, they saw opportunities to not only increase awareness of Primary Health Care and the services it provides, but also reinvent the agency.

“We got lost in the bowels of a larger organization for over 20 years and I don’t know if anybody knew who we are,” Engebretsen said. “There are many opportunities in the midst of this to do things differently, to look at ourselves differently and to look at this community differently.”

For example, he said, the agency’s ability to react quickly to the rapidly changing field of health care was limited when it was part of a larger organization. “We said very quickly that this is probably, in the long run, going to be a real plus for us. To be perfectly honest, it’s going to be a real plus for Broadlawns, too.”

Though its ability to serve patients has been limited due to budget and staff reductions, Broadlawns still has a core mission to provide medical services to indigent and underinsured people. “They have to pick up what we leave behind,” Engebretsen said. “They’re saying that is their plan, and they did pick up a lot of our staff.”