It’s about 1 p.m. on a Tuesday, and Dr. Julio Menocal has already seen 50 patients during the day.

He spent the majority of his lunch break dealing with two pharmaceutical company representatives, who came in with name tags pinned to their crisp suits.

The doctor sits behind his desk, his white coat loosely buttoned. His eyes are bloodshot.

He’s exhausted.

He says he has only a few months of this left in him — leading his staff, paying the bills, seeing patients — but he can’t leave when there’s so much work to do.

Menocal is a savior for thousands of people on Frederick’s Golden Mile who can’t afford health care. He has made an impact, especially in the Hispanic community, where access to care is a luxury for some.

According to Census estimates from 2014, about 23 percent of Hispanic residents of Frederick County don’t have health insurance. In the majority white population, about 5 percent are uninsured.

But Menocal thinks 23 percent is a low estimate. For every one of those county residents counted in the Census, he believes there are four non-citizens who go uncounted.

There are about 32,000 patients in his territory area along the Golden Mile who qualify for medical assistance programs, including Medicaid. Menocal cares for about 5,000 of them.

But you have to be a U.S. national, a permanent resident or a citizen to qualify for Medicaid, and Medicaid doesn’t cover everything.

Diego Chavez, 22, moved to the U.S. from Guatemala 10 years ago. His parents took him here to get better care for the scoliosis he’s had since he was a child.

Chavez has never been able to walk and has had multiple operations to adjust his severely curved spine and realign his hips. He gets around in an electric-powered chair he steers with his left hand.

Scoliosis affected much of his physical development, pulling his head and limbs in different directions, according to his father, Marco Chavez.

“His head, before the surgery, looked like this,” he said, laying his hand on his son’s right shoulder, indicating that Diego’s ear was parallel with it.

While Diego attended West Frederick Middle School, a social worker at the school helped get his family in touch with the Shriners Hospital for Children in Philadelphia. The hospital paid for Diego’s treatment, but Marco had to take time off from work to get him to the hospital.

“They had to go several times a week,” said David Moreno, a support coordinator at The Arc of Frederick County, which assists people with intellectual and developmental disabilities. “It was a lot for them.”

The organization helped Marco’s family by providing gift cards for gas and groceries. The Arc also helped the family pay the rent on their Frederick apartment so they could afford a van big enough to fit Diego’s electric-powered chair.

Marco fixed computers through a home business to try to make enough money to care for his family and get Diego to his doctor’s appointments.

If it weren’t for The Arc, Marco said, “I don’t know what we would do.”

Diego does not have health insurance and has not had a physical checkup in years. He is living in the country on a deferred-action permit that does not let him take advantage of Medicaid.

“Diego’s an example of many, many families we have served,” Moreno said.

Though Diego has needed physical therapy since his surgeries, he and The Arc could not find a therapist willing to provide those services at an affordable rate.

“We wish there was more access for health. ... It’s not just [treating] a cold. There’s a real, desperate need,” Moreno said.

Maria Shuck is director of Centro Hispano de Frederick, which provides referrals, translation services and English-language classes.

Shuck is also a certified medical interpreter at Frederick Memorial Hospital who speaks Spanish and English.

At the hospital, Shuck often translates for many people who come from Central or South America and don’t have health insurance.

“They end up here, in the emergency room,” Shuck said. “A lot of times, it’s because they don’t have a primary care provider.”

When she started at her job 14 years ago, Shuck said, she provided translation services for about three to five patients each day. Now, she translates for 30 to 40 patients a day.

At Menocal’s office, staff will generally ask struggling patients how much they want to pay for their care.

“As long as you walk into the office, you don’t get turned away,” he said.

About 70 percent of his patients get financial help for their medical needs from the state through Maryland’s Medical Assistance programs. Most of those patients are children.

“The biggest challenge is getting someone who can accept them in their office,” Menocal said.

The doctor and his staff have struggled to keep the practice above water while they accept more patients who need financial help. They recently bought a new retina-scanning machine to check patients’ eyes, but it’s sitting unused in an exam room.

“Currently, we cannot use it, because we’re falling behind in payments,” he said.

That doesn’t stop him from pushing for a better quality of life for his patients. His fundraising efforts with The Community Foundation of Frederick County and Frederick County Public Schools helped get hundreds of tablet computers for elementary and middle school students who qualify for the county’s free and reduced-price meal program.

“We are hellbent on getting these kids computer literacy,” Menocal said.

He believes that reducing health disparities, especially for those who speak English as a second language, starts with education.

“An educated patient is a healthy patient,” Menocal said.

Shuck and Moreno agree. While Menocal wants to motivate children to educate their parents, Shuck said health providers should make information available in multiple languages as well.

“In the meantime, while these folks are learning this new language, we still need to offer services in a language they feel comfortable with,” Shuck said.

When provided only with materials written in a foreign language, Moreno said, people have fewer options for their health.

“Whether it’s in the health area or other types of resources, we see that without information, there’s no opportunities for choice for individuals or families,” he said.

Follow Sylvia Carignan on Twitter: @SylviaCarignan.

(18) comments

ddegrangejr

Being we are throwing out numbers, I would like to know of the 23% of hispanics, compared to 5% of whites, how many more illegally get services of other sorts? (Food Stamps, WIC, ETC...) I lose 30% of my paycheck in order to give my family health insurance... My wife and I work and have trouble making ends meet and yet our friendly social services office told us we would have to get separated or divorced in order to receive any help... why? Why would you help illegals or those that just flat out choose to live off the system rather than those who work hard and just need a little help to get by... When the government starts taking care of those who work hard and earn it, then and only then do those who would rather keep having babies for help or those who just choose to live off the system should be helped. For those with a legit reason, why don't we try and HELP THEM!!!

vicdavy

ddegranggejr, There is always some resentful xenophobic narcissistic racist like you attacking a Great Man! Dr. Menocal is a Doctor not a politician. He has helped my family before the ACA was passed and I am a Vietnam Veteran who stood up for my country and I am not Hispanic or Illegal! Born in the USA and my Humanity ,as does the Doctor's, goes beyond Borders! I pity your ignorance.

ddegrangejr

you can call me racist all you want. I have no problems with anyone... Especially not those who come here legally. My problem is when the system fails those who work hard to support their families and reward those who do not or do not do so legally. I applaud Dr. Menocal in his efforts, however if I take my family to see him will I get privileges also? Two of my best friends are from El Salvador and Guatemala and came here legally, work hard to support their families and earn what they are given. How about all the homeless vets that can't even get this sort of treatment? Thanks for your service and piece of enlightenment... However you know what they say... Opinions are like [censored] everyone has one

vicdavy

He will see anyone in need! You are talking out your Butt cause you don't know! I have known this man for 25 years and he left his previous practice at Parkview Medical because they stopped accepting Medicare and Medicaid patients! My sister-in-law had no money and no insurance and when the accounting people said they could not help her,he came out of the back and said,"We turn no one away!" You sound like a Trump supporter!

chyandqt

[thumbup]

bosco

I too applaud his humanity and dedication, but if there was no free ride for people not here legally, he would not be overworked. He is as much of an enabler as the people who hire those here illegally. If there were no jobs, housing, advocates, and services for those here illegally, there would be no incentive for them to be here - and essentially butt in line ahead of those who follow the law and immigrate legally.

chyandqt

[thumbup]

jsklinelga

ddegrangejr,
i understand your frustration. i know many working families that cannot afford insurance but that should not stop you from singing high praises for this Doctor. God bless this man and his work.

vicdavy

If this country had Universal Healthcare for All American citizen there would not be all this whining! I guess the Doctors without Borders should be considered traitors,right!
Someday, if America finally grows up, we can lead the World as Earthlings for All Mankind!

MrHitshed

Thank you, Dr. Menocal, for everything you do.

bosco

Dr. Menocal is no doubt a saint in his efforts, but his behavior is an enabler for illegal aliens, just as are employers who hire them. Immigrants who enter this country through legal means are eligible for social services to help them transition toward citizenship. Those who enter through illegal means are here unlawfully.

gary4books

Not all Hispanics are illegal. You come out of left field.

johnqFrederick

@Dr. Julio Menocal -- I will pledge $75 per month to your practice to assist; if I can provide more, I will. Community Based and Faith Based organizations are the eyes and ears for our community. No one should go without basic care, regardless of status.

vicdavy

[thumbup][thumbup][thumbup]

gary4books

I am impressed. [thumbup][thumbup]

gary4books

Bravo [thumbup][thumbup][thumbup][thumbup]

vicdavy

Dr. Menocal is our Doctor and he's the best! I don't see how he does it ,but he is the true definition of a Doctor! God Bless You, Doc!

gary4books

He is also my family physician.

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