The Federal Poverty Level is adjusted year. For example, 200% of the Federal Poverty Level for a family of four is currently $44,100. It is not the desire of these families not to have health insurance; it is a reality that in paying for housing, food, clothing and transportation there is no money to pay health insurance premiums.
When we state “free” we mean that there are not charges for our services. We do ask, in many cases, that the patient make a contribution to cover some of the expense. The usual contribution request is for $3.00 to $5.00. No patient is denied service if they cannot make the contribution. The donation seems to have apositve affect on patients in that these individuals are better about taking their medications and about coming to follow-up appointments.We do not accept patients who have public support in the form of Medicare and Medicaid, or have private insurance.The free clinics do not bill any third party for services provided in the clinic. This is a distinction between the Free Clinics and the Federally Qualified Health Centers such as the Clinic here in Harrisonburg. These organizations bill Medicaid and Medicare, and private insurers for their services. As well, the Community Health Centers do treat patients without insurance and the patients pay on a sliding scale. The Community Health Centers are our partners in Virginia’s Health Safety Net.
The number of unduplicated patients increased by 8% from 2007 to 2008. The number of patients from 2008 to 2009 increased by 12%. This is a total of a 20% increase over two years. During the first three months of FY 2010 clinics within the Association were adding conservatively 1800 patients each month. Also during the same period, for clinics that track information about newly uninsured patients an average of 54% of new patients were uninsured.Some clinics struggle to increase the number of patients served. An the time between becoming financially qualified and receiving service has continued to increase. the last quarter some clinics have seen as much as a six week time period.
Both types of organizations provide services to individuals who are at, or below, 200% of the Federal Poverty Level.
With an overall growth of 20% in unduplicated patients from 2007 to 2009, Free Clinics, also, experienced a dramatic increase in the number of patient visits.The ratio of patients visits climbed from 3.40 per patient in 2007 to 4.55 per patient in 2009. The increase was due to the number of patients, to more intensive monitoring of patients and more counseling related to medication regimes. Our patients are sicker than the general public because patient have delayed treatment. Many times people who are newly unemployed are embarrassed to seek help from a free clinic and have delayed treatment and have not taken vital medications for some period.
These numbers reflect the increase in patients. There was an increase in the number of prescriptions per patient from 10.1 to 10.8 from 2007 to 2009. The numbers in the screen reflect the number of prescriptions dispensed by the clinics. We do not track those prescription which are written by our medical providers and the paid for by our patients. This number has increased significantly with the $4.00 formulary pricing provided by such organizations as Wal-Mart, Target, CVS and Walgreens.
The number of clinics have increased from 32 in 1999 to 56 currently. Seven new clinics have joined the Association since March. There are three new applications under consideration at this time.
The Association’s membership provides services to 81% of the cities and counties in the Commonwealth. Seven new clinics have added in 2009; these clinics are highlighted in red. They are the Health Wagon in Dickenson County, the Christian Free Clinic of Botetourt, The Orange County Free Clinic, the Hanover Interfaith Free Clinics, the Tappahannock Free Clinic, Western Tidewater Free Clinic in Suffolk and Pathways in Petersburg. There are two applications under consideration are the yellow squares on the map. Three clinics, the white squares with green centers have indicated they wish to join when eligible. The two black squares with red centers are locations where the VAFC is assisting groups to form new clinics.New members are: Christian Free Clinic in BotetourtHealth Wagon in Dickinson CountyOrange County Free ClinicHanover Interfaith Free ClinicsTappahannock Free Clinic in Essex CountyWestern Tidewater Free Clinic in SuffolkPathways Free Clinic in PetersburgThree current applications:Culmore Free Clinic in Fairfax Powhatan Free Clinic Pending applications:Wesley Free Clinic in AbingdonKing George County Free ClinicGroups forming:Page CountyNottoway CountyCaroline County
These seven conditions are in rank order of the chronic diseases that are being treated in member clinics. Most Free Clinic patients suffer form more then one of these conditions which are called co-morbidities.These conditions are the same chronic conditions found in the American society generally. However as I remarked earlier, when a patient comes to a free clinic the individuals medical situation is usually worse than the average patient because the patient has delayed treatment due to lack of insurance, job conflicts, lack of transportation, embarrassment about coming to a free clinic, or the fact that the individual was not aware of the free clinic and its services.Unfortunately these chronic health issues that exist in the American society are related to our lifestyle more than any other reason.
The cost of an individual prescription for 731,437 prescriptions was $6.65.For each dollar provided by the Commonwealth, the Free Clinics provided $43.12 worth of medication.
The Lackey Free Clinic in Yorktown is one example of the impact a clinic can have in a community. Virginias’ s Free Clinics working with other partners in the Health Safety Net and local hospitals and specialty providers are an efficient method of meeting the needs of people who are at, or below, 200% of the Federal Poverty Level and cannot afford health insurance.
Virginia Association of Free Clinics
Free Clinics – The Exploding Needs in a Struggling Economy<br />Louis M. Markwith<br />Virginia Association of Free Clinics<br />November 15, 2009<br />
Outcomes<br /> “I had to quit my job due to not being able to function appropriately on a daily basis. That was hard for me to face being at a free clinic. The staff listened and immediately began a treatment plan of blood work, and routine x-ray, followed by a CT scan, and within two days I was diagnosed with cancer. I cannot imagine what would have happened to me without their expertise and quickness. I commend all the staff and thank God for having their support in our community and for myself. It is a relief to have the clinic by my side during this fight for life.”<br /> <br />- Words from an Augusta Regional Free Clinic Patient<br />
People we serve<br />“Free Clinic patients are people who are at, or below, 200% of the Federal Poverty Level and cannot afford to purchase Health Insurance.”<br />
What is Free Clinic<br />“a private, nonprofit, community or faith-based organization whose primary mission is to provide health care services free” …<br /> “a facility that provides diagnosis and treatment of patients and maintains patients’ records.Volunteer health professionals provide a significant portion of health care services.”<br />
Current Climate<br />There 650,000 people in Virginia who would qualify for services from the Health Safety Net.<br />Free Clinics and Community Health Centers served approximately 155,000 qualified patients in FY2009.<br />Current Health Care reform will reduce the number of people who will be uninsured in Virginia. The number is fluid as this time.<br />Gaps will continue to exist as there are not enough<br /> trained medical professionals in current educational<br /> programs to meet the demand for service.<br />
Patient Conditions<br /> Jane came to the Free Clinic with an open sore on her leg. The Free Clinic tested the site and it was determined to the Methicillin Resistant Staphlycoccus Aureus (MRSA). She was treated by Free Clinic providers.<br />
Free Clinic Vs. CHC<br />Free Clinic<br />95% Volunteer Staff<br />80% Operational Funding<br /> Community Based <br />20% State Funding<br />No Insurance Reimbursement<br />No Patient Fees<br />Donations requested <br />Community Health Ctr.<br />Full Time Staff<br />Billing of Medicare, Medicaid, Private Ins.<br />Federally Chartered and Subsidized<br />Patients without insurance charged on a sliding scale<br />
Patient conditions<br /> Gary came to the Free Clinic with abdominal pain. He was found to have an abdominal aortic aneurysm measuring over five centimeters. He was scheduled for surgery.<br /> <br />
Seven Clinics Accredited, Three in the queue for testing</li></li></ul><li>Medications/Pharmacy<br />Return on Investment<br /> State Investment $1,321,400<br /> Clinic Investment 3,543,865<br /> Total $4,865,265<br /> Free Medications $56,989,637<br />
Health Care Services<br />Return on Investment<br />State Contribution $1,875,000<br /> Number of Visits 51,914<br /> Cost per Visit $36.11<br /> Patients Served 23,983 <br />
Lackey Free Clinic<br />Return on Investment<br /><ul><li>Budget 2008 $1,300,000
Return on Investment 9.7 to 1</li></ul>*Reduction in hospital ER visits and charity admissions<br />
Outcomes<br />Kathy of Timberville lost her job because of atherosclerosis. She became qualified for service from the Harrisonburg-Rockingham Free Clinic in March, her only option. She circulation problems have improved and the Clinic has helped her stop smoking.<br />She has a new job, but still no health benefits<br />