Vaughn Beard of Funkstown gets a routine medical follow-up from Dr. Don Richter at the Walnut Street Community Health Center. Seeing insured and uninsured patients alike, Walnut Street is one of several organizations in the area that help form a safety net for some patients.
Everyone has a basic need for healthcare. But when the costs of insurance, deductibles or life-sustaining medications are too high, or a job loss leads to a family suddenly finding themselves outside the familiar healthcare infrastructure, it can be hard to know where to turn for help. And despite the fact that more people than ever have access to insurance because of the Affordable Care Act, there remain many people who fall through the healthcare system's cracks for one reason or another. Thankfully, for those in need of healthcare, local organizations are there to help – providing a range of affordable care and even free care for uninsured patients.
Community Free Clinic Executive Director Robin Roberson and Program Director Adam Roberson see their nonproﬁt as a lifeline and a safety net for the uninsured in Washington County.
Washington County and Franklin County, Pa., each are home to a federally qualified health center (FQHC), which receive grants from the federal government, qualify for enhanced reimbursement from Medicare and Medicaid, as well as other benefits, according to the U.S. Department of Health and Human Services. Among other requirements, FQHCs must serve an underserved area or population and offer a sliding fee scale.
Franklin Countyʼs FQHC, Keystone Health, serves about 47,000 patients and has grown substantially since its founding in 1986 as a program to provide healthcare and human services to migrant and seasonal farm workers. As co-founder and current Keystone Health President and CEO Joanne Cochran recalls, demand swiftly grew, nearly tripling from between 300 and 400 patients initially to about 1,200 in the programʼs third year. “By 1991 the winter population was larger than the summer, and I couldnʼt tell the difference between the migrants and the poor in the community,” Joanne says. “I decided we better expand the program.” She completed the complicated process to become a federally qualified health center, and Keystone Health began to expand its offerings beyond family medicine.
Today, Keystone Health encompasses family medicine, dental care, speech and audiology, behavioral health, urgent care, pediatrics, a pharmacy, womenʼs care/OB/ GYN, internal medicine, infectious disease, and cardiology services. “Our mission is, we provide services to anyone and everyone regardless of their ability to pay, regardless of their disease,” Joanne says. Insured and uninsured patients alike can access care, with a sliding fee scale for those without insurance.
In Hagerstown, Walnut Street Community Health Center has been a FQHC since 2003, caring for about 7,000 patients ranging in age from infants to geriatrics. “They can be insured or uninsured, and most of our population is from the Hagerstown area,” says Executive Director Kim Murdaugh, MPH. Being able to accept both insured and uninsured patients, Kim says, offers peace of mind to people who find themselves in a state of change regarding jobs and insurance status. “You can continue to come here. And sometimes with the economic conditions, people are changing jobs, so itʼs nice to know that thereʼs one thing that doesnʼt have to change.”
Walnut Street started with a family practice and a pediatric dental practice, and has since grown into a comprehensive program offering mental health integrated within primary care, general dentistry, lab services, a case manager who works with people to address barriers to improving their health, and more, all in one building. A 39-foot mobile dental program, Healthy Smiles in Motion, serves children in Washington County Public Schools and Head Start. “Through the mobile program we can do anything from filings, extractions, pretty much what we can do here,” says Kim, adding that the practiceʼs electronic medical and dental records ensure continuity of care.
In July, Walnut Street Community Health Center will become Family Health Care of Hagerstown when the practice moves to a larger location on Cleveland Avenue in Hagerstown. “We have more demand for care here than we can actually physically accommodate,” Kim says. The new building will include more exam rooms and additional dental operatories, accommodating additional staff and allowing the practice to accept new patients.
Dr. Sarma Metz performs a dental exam on patient Kurt Schroder at Walnut Street Community Health Center, which will open in a larger location in July as Family Healthcare of Hagerstown.
While federally qualified health centers are able to provide care to uninsured patients at a reduced cost, other organizations have chosen not to seek that designation so that they can provide care to patients free of charge. “Our mission is to be a healthcare safety net for citizens of Washington County who are medically uninsured, to provide healthcare for those folks who have nowhere else to go,” says Robin E. Roberson, executive director of Hagerstownʼs nonprofit Community Free Clinic, which is now in its 25th year of operation. “All of our services are free.”
The Community Free Clinicʼs services span acute and primary care, chronic disease management, womenʼs health, mental health, access to specialists in rheumatology, neurology, orthopedics and more, and lab and X-ray services. “We see everything,” Robin says. “It could be something as simple as an ear infection, or something as serious as an aortic aneurysm rupturing.” Ancillary classes educate diabetics on proper eating and how to manage their diabetes, for example. “In addition to that we have medication distribution, so we work with pharmaceutical companies ... so that we can distribute medication to our patients only,” says Program Director Adam Roberson. “From a medical perspective, itʼs very holistic,” he adds.
On the other side of South Mountain, faith-based nonprofit Mission of Mercy aims to “restore dignity and ʻhealing with loveʼ at mobile clinics, providing free medical and dental care and free prescription medications to the uninsured and underinsured,” says Dr. Michael Sullivan, chief medical director. Dr. Sullivan founded Mission of Mercy with his wife, pharmacist Dr. Gianna Talone-Sullivan, in response to a divine inspirational call she experienced. Their first clinic opened in Brunswick, Md., in 1994, followed by Frederick, Taneytown and Reisterstown in Maryland, and Gettysburg and Harrisburg in Pennsylvania.
“We treat a broad spectrum of conditions such as high blood pressure, heart disease, rheumatologic conditions, or diabetes,” Dr. Sullivan says, “using a mobile van that is stocked with medications, and has three patient examination rooms.” Patients are not qualified by income or citizenship. “Patients basically qualify by coming to us with a health problem when they do not have comprehensive healthcare coverage thatʼs affordable to them.” Dr. Sullivan says. “The need is great, especially in the area of dental health care, which is at a critical point. Many of our dental patients arrive as early as 2 or 3 a.m. in order to assure that they are seen at one of our eight or 10 dental slots available each day.”
Certiﬁed Registered Nurse Practitioner Mary Perkins (right) checks Mary Martinʼs heart rate and blood pressure at the Community Free Clinic. Most of CFCʼs medical practitioners are volunteers.
The Community Free Clinic and Mission of Mercy are able to provide free care thanks to a network of community partnerships, as well as dedicated fundraising efforts. “We have about 35 providers that come into the clinic, and theyʼre all volunteers. We only have one paid nurse practitioner here on staff,” Robin says. “Weʼve also built a network of physicians in the community who are mainly specialists, who will see our patients in their office for either no fee or a very reduced fee.” Relationships with Johns Hopkins Hospital and the University of Maryland help patients with severe, life-threatening issues access critical care that canʼt be handled in Washington County.
Mission of Mercy has always partnered with the Frederick County Health Department, which provides services such as breast screening, the Mental Health Association, and Frederick Memorial Hospital which, since 1995, has provided lab assistance and X-rays. “We have recently been fortunate to add two physical therapists to our volunteer providers in Frederick County,” Dr. Sullivan says. “But we really need another one to two primary care doctors to volunteer and rotate through our program,” as well as subspecialists like optometrists, chiropractors, or oral surgeons who are willing to take referrals from Mission of Mercy.
Though many volunteers provide free care, there are costs associated with practice insurance, medications, operations and more, and fundraising ensures these organizations are able to keep serving patients in need. Because the Community Free Clinic does not receive state or federal funds, grants make up a large portion of its budget and fundraisers account for between 25 percent and 30 percent. Signature fundraisers like the Silent and Lively Auction at the Gourmet Goat, the Potterʼs Bowl and the MUDD Volleyball Tournament (coming up in July) are paired with benefits held by other organizations for the clinic. Even during the recession, when giving to nonprofits was down, “the Washington County community has always accepted us and always embraced us, and they really stepped up to the plate during that time and helped us out during a great time of need,” Adam says. Mission of Mercy also raises its operating funds year to year, with events like golf tournaments in June and September helping to support clinic operations. “Coffee with M.O.M.” tours of the Frederick clinic are held 10 to 11 a.m. on alternate Mondays so guests can meet the doctors, dentists, staff, and patients and see Mission of Mercy in action, Dr. Sullivan says.
Healthy Smiles in Motion provides dental care to school children, getting them the care they need with less time out of the classroom.
Having access to healthcare can literally mean the difference between life and death. And that care, coupled with compassion and dignity, is healing both for the individual and the greater community. “Itʼs a lifeline,” Robin says of the Community Free Clinics services, “because many of these patients would not be alive if they did not have access to medication,” specifically diabetics, patients with high blood pressure or those who have had strokes. And itʼs a safety net, Adam adds: “We see a lot of short-term patients as well. They might be between jobs without insurance. They might be predominantly healthy and not have an issue, but then something comes up. Thereʼs a lot of different scenarios that happen.”
“If it werenʼt for the grace of God, there go I,” says Keystone Healthʼs Joanne. “Any one of us could be in the situation that people are walking in our doors with.” That sense of compassion has permeated Keystoneʼs mission since its origins in caring for migrants. “Migrant farm workers have been given a bad rap,” Joanne says. “When I think of migrant, I think of a man and a woman who are out in those fields from the minute the sun breaks in the morning until the sun goes down at night, with their little kids helping them with these big canvas bags strapped to their back. They work incessantly and their big concern is theyʼre just trying to make a life for their kids.”
As with the other community health providers, Keystoneʼs keystone is caring. “We all share the same mission: we want to make a difference in the lives of everyone,” Joanne says. “We want to improve their lives, every person who crosses our threshold.” And patients notice, Dr. Sullivan says: “Judging by the looks on their faces, and the hugs and smiles between patients and all of our doctors and staff, I think our patients are comfortable with the care they receive and the dignity with which they are treated.”
Participants in the Community Free Clinicʼs MUDD Volleyball Tournament, scheduled for July 18, are as serious about getting dirty as they are about raising money to support its mission.
And when those patients receive the care they need, the whole community is healthier. Adam recalls Community Free Clinic patients like a gentleman who needed help stabilizing his diabetes after being released from a correctional facility. “We spent a lot of time with him, helped him get his health in order,” Adam says. “The next time he came in, he had a short hair cut, was clean shaven. He was maintaining work. So thatʼs another piece of what our mindset is: Weʼre here to help people maintain their health but also to get healthy so that they can go back out into the community and be an asset.”
Kim at Walnut Street agrees: “Healthier people are going to go to school. Theyʼre going to learn. Theyʼre going to be able to go to work and also contribute back to the community. If you have a lot of health issues, obviously youʼre not going to be as active; youʼre not going to be able to do that. So itʼs better for the individual, and I think certainly itʼs better for the community as well.”