81K extra visits: How Cook County Health is meeting migrant healthcare demands

As one of the Midwest's largest public safety-net systems, Cook County Health has cared for more than 19,000 migrants since fall 2022, about one-third of whom are children.

The Chicago-based system, which sees more than a million healthcare visits a year, has recorded an additional 81,000 visits involving migrants.

"We see a lot of patients at Cook County Health, so just adding in all those people at one time is a bit of a stress," Claudia Fegan, MD, chief medical officer of Cook County Health, told Becker's. But the system has risen to the occasion, significantly expanding its capacity over the last year-plus to address the needs of Chicago's growing migrant population.

Cook County Health transformed one floor of a clinic into a dedicated migrant care site and recruited additional employees to help meet this increased demand, including physicians, advanced practice registered nurses and clerks. Some physicians — especially those who are bilingual — have also volunteered to work additional shifts, according to Dr. Fegan.

The health system collaborates with the Chicago Department of Public Health to coordinate care for new migrants. The department sends Cook County Health a list of new migrants every day, and volunteers conduct health assessments to identify anyone with urgent health needs.

Initially, all migrants are screened at the dedicated clinic site for infectious diseases, behavioral health needs or other health conditions. Children also undergo a full physical and receive any necessary immunizations so they are school-ready.

"Fortunately, a majority of the migrants are healthy, and so they don't need ongoing care," Dr. Fegan said. Patients who do need ongoing care are distributed across the system's network of ambulatory clinics to prevent capacity strains.

Though it's been a challenge to quickly ramp up capacity, Dr. Fegan said the system wanted to ensure this patient population still received thoughtful, high-quality care.

"We've had to stand up a lot of access in a very short time for people who arrive unexpectedly, and I think we've done it in an appropriate fashion — not just to check the box."

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