Local health care clinics see rise in the needy
Lynchburg News and Advance
Saturday, March 14, 2009When James Moore needed open heart surgery, he faced a cruel irony: He was an insurance adjuster who could not afford health insurance. The medicals bills piled up. His prescriptions alone cost upwards of $700 a month. To cut costs, Monroe, 52, skipped doses and stopped taking some medicines altogether.
The burden became too much. In April, the Appomattox native registered for medical services at the Free Clinic of Central Virginia in Lynchburg.
“I put it off as long as I could, he said. “I never had to come here before in my life.”
The Free Clinic provided a much-needed safety net. Now, at $2 a bottle, Monroe’s medicines cost $14 a month.
“It’s great here, once you get out of the waiting room,” he said with a chuckle, scanning the crowded seats.
Moore is part of a rising tide of people seeking free or reduced-price health care services in the wake of skyrocketing health care costs and a nationwide recession. Two local clinics that target the low-income community — the Free Clinic and Johnson Health Services — have experienced a spike in demand in recent months.
At the Free Clinic, the number of new patients registered for medical and/or dental services has surged. Last month, the clinic registered 160 new clients, more than double the 77 registered in February 2008.
The Free Clinic typically serves the working poor. In 2008, 70 percent of its clients worked, sometimes one or more part-time jobs. Since the recession took hold, a new demographic has come to its doorstep — families from higher income brackets facing job layoffs or rising insurance premiums.
“We’re seeing upper-low class and lower-middle class, people who have never availed themselves of help before,” said executive director Bob Barlow.
Demand for low-cost health care is also increasing at Johnson Health Services, a Federally Qualified Health Clinic that receives federal funding and is the primary provider for many of the area’s Medicaid patients.
Between November and January, the clinic saw a 17 percent rise in applications for its reduced-fee program.
“The Johnson Health Center has been overwhelmed with phone calls and applications for adults and children who are looking for a medical home,” said Sara Manley, the reduced-fee coordinator.
Eligibility for the reduced-fee program is determined through federal poverty guidelines, household/family size and income. Doctor’s visits cost be-tween $25 and $80 per visit. People who are unemployed are approved for three months, giving them time to find a new job.
“We may see an increase in the number of people renewing in the next few months if they can’t find work,” Manley said.
In 2008, 75 to 80 percent of Johnson’s patients had Medicare or Medicaid, while 15 percent were uninsured.
“It been up to 25, 30 percent in years past. We’re expecting that number to spike again this year,” said medical director Dr. Joseph Teel of those without insurance.
Rising unemployment has been a major contributor to the increased caseload at the Free Clinic and Johnson Health Services. The unemployment rate in Lynchburg in January was 7 percent, well over the 3.9 per-centage rate in January 2008, according to the Virginia Em-ployment Commission.
“A lot of people are losing their jobs, whether it be the construction business or the banking business,” Manley said.
“We have a lot of new patients here that we’ve never seen before.”
Both clinics have experienced what Barlow describes as the “delayed effect” or a lag time of weeks or months before a family looks for a new medical home after losing benefits. For those with acute medical needs and expensive medicines, it can be sooner rather than later.
“People don’t come in and apply for services until their backs are against the wall,” Barlow said.
With the economic outlook grim, leaders at both clinics expect to feel the effect of the influx of patients for the foreseeable future.
The Free Clinic will receive $100,000 in state funding for the next fiscal year, the same amount as last year, while budgets across the state are getting cut. Private donations, which account for about one-sixth of the operating budget, were down during the Christmas season.
As demand has increased, so has the Free Clinic’s vast volunteer staff. Barlow has been recruiting more eligibility screeners to get people enrolled for services, and long-time volunteers are stepping up their hours.
Two years ago, Dr. Paul Fitz-gerald ran the orthopedic clinic once or twice a month. Now he comes three to four times a month, sometimes more.
“If I could physically, I could probably see patients two to three times a week,” said Fitzgerald, a retired orthopedic surgeon.
The only service that is under strain at The Free Clinic right now is the dental clinic, Barlow said.
“We just don’t have enough time or enough slots to meet the expanding needs,” said Barlow, who is exploring options to ex-pand its offerings.
For Johnson Health Services, it’s a delicate balancing act between providing low-cost care and taking in enough money to keep its doors open. The center is looking to hire more primary care providers to meet the grow-ing demand, and expand its presence in the surrounding counties, Teel said.
“I don’t think we’ve fully absorbed the effects just yet,” he said.
Teel is optimistic about the long-term outlook of community health clinics. He expects Feder-ally Qualified Health Clinics to be on the forefront of health care reform, and is already seeing evidence of increased funding.
For example, the budget of the National Health Service Corps, which trains primary care physi-cians for service in low-income communities, doubled for this coming year, thanks to the American Recovery and Rein-vestment Act of 2009. Teel is a scholar of the program, which is how he ended up at the Johnson Center in Lynchburg in 2006.
“I think the outlook overall for community health centers is actually pretty good given the new administration’s focus on helping the uninsured in this country,” Teel said.
Johnson Health Services is hosting a Benefits Fair on March 28 from 10 a.m. to 2 p.m. in the pediatric clinic at 407 Federal St. in honor of “Cover the Uninsured Week.”
“Because the economy has gotten so bad and we’ve really started to feel it, we want to provide an outlet for people in the community to know what benefits are available,” said the clinic’s reduced-fee coordinator Sara Manley.
The event will provide information on the free services through Social Services, Legal Aid, the Boys and Girls Club, Planned Parenthood, The Alli-ance for Families and Children and others.
Attendees will be able to talk one-on-one with a social worker to apply for programs like Temporary Assistance for Needy Families, food stamps and general relief. Those interested in services should bring photo identification, birth certificate and proof of income.
For additional information, contact Sara Manley at (434) 200-6410
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